艾滋病毒自检:及时了解自身情况!

世界卫生组织 2016-12-02 19:35

艾滋病毒自我检测为亚太地区约180万名不清楚其自身状况的艾滋病毒感染者提供了一种可用的新方法。世卫组织在今年世界艾滋病日前发布的新指南中建议,在'...

艾滋病毒自我检测为亚太地区约180万名不清楚其自身状况的艾滋病毒感染者提供了一种可用的新方法。世卫组织在今年世界艾滋病日前发布的新指南中建议,在提供的艾滋病毒检测服务中增加自我检测。对于西太平洋区域而言,个人能够进行艾滋病毒自我检测,可帮助男男性接触者、注射吸毒者、性工作者和变性者等重点人群克服获取艾滋病毒检测服务时常见的法律与社会障碍。

艾滋病毒自检,为自身健康负责

“鉴于自我检测方法的高度保密性,我们强烈支持推广艾滋病毒自我检测,这对遭遇耻辱歧视的人群非常重要”,高棉艾滋病非政府组织联盟(KHANA)执行主任Choub Sok Chamreun表示。“ 这是发现难以接触和得不到医疗服务人群的新工具,能帮助到柬埔寨最后一名感染者以实现终结艾滋病的目标。同样重要的是,它能让个人主动为自身健康负责。” Chamreun说,近期的调查显示,艾滋病毒自我检测法在柬埔寨娱乐工作者、男男性接触者和变性女性中接受度很高。

西太平洋区域的一些国家已经开始采取措施支持艾滋病毒自我检测。2014年,澳大利亚取消了对于艾滋病毒自我检测的限制,修改了法规,允许销售用于自我检测的艾滋病毒快速诊断试剂。越南在三个省进行了试点,并于2016年8月首次推出艾滋病毒自我检测服务。中国也开展了改善自我检测服务可及性的试点,如,通过社区组织向重点人群发放口腔自我检测试剂盒以及血液或尿液检测试剂盒。中国已有几所大学的校园配备了销售低成本的尿液检测试剂盒的自动售货机,样本可送往有质量保证的实验室进行艾滋病毒检测。检测者可以通过手机App凭唯一编号匿名查询结果。

世卫组织建议监管自检服务

西太区目前出现了自我检测试剂盒通过私人药店及网上零售商进行无监管的非正式销售的现象,对此应做出公共卫生回应。随着各国正通过正式的社区、医疗机构和网络等渠道提供艾滋病毒自我检测服务,世界卫生组织也提出了一些建议,比如,建立销售的政策与监管框架,以确保用于自我检测的艾滋病毒快速诊断检测的质量与安全。

其他建议包括服务提供模式应与现有的艾滋病毒检测服务相辅相成、检测结果应与确诊检测和治疗服务挂钩等。自我检测结果阳性者应在正规医疗机构做进一步检测,以确认结果。因此,为自我检测者提供明确的信息很重要,比如,如何解读检测结果,以及如果需要后续检测与治疗,如何便捷地获得医疗服务等。

“我们注意到自我检测试剂盒的网上销量明显增加,所以,社交网站等网络平台是向自我检测者传递信息与提供支持的有效工具。我们正在密切监控获得确诊检测的人数,以确保至少符合我们基于销售量所作的判断。将艾滋病毒检测阳性者转介给治疗机构十分重要。”

——吴尊友博士

主任

性病艾滋病预防控制中心

中国疾病预防控制中心

HIV self-testing provides an opportunity to know your status in private

HIV self-testing is an empowering and innovative way to reach the estimated 1.8 million people living with HIV in Asia and the Pacific who do not know their status. The new WHO guidelines released ahead of World AIDS Day this year recommend that self-testing be offered as an additional HIV testing service. For the Western Pacific Region, having the option for an individual to perform an HIV test on his or her own will help to overcome legal and social barriers to HIV service access often faced by key populations, including men who have sex with men, people who inject drugs, sex workers and transgender people.

“We strongly support making HIV self-testing available given that it ensures high confidentiality, which is very important to people experiencing stigma and discrimination,” stated Mr Choub Sok Chamreun, executive director of the Khmer HIV/AIDS NGO Alliance (KHANA). “It can be one of the innovative tools to find those who are hard to reach and have yet to access services, and help reach that very last person living with HIV in Cambodia to achieve the goal to end AIDS. Equally important is that it enables the individual to take ownership and leadership for his or her own health.” Mr Chamreun reported that recent surveys show high acceptability for HIV self-testing among Cambodian entertainment workers, men who have sex with men and transgender women.

Some countries in the Western Pacific Region have already taken steps to support HIV self-testing. In 2014, Australia lifted restrictions on HIV self-testing and amended regulations to allow the sale of HIV rapid diagnostic tests for self-testing. Viet Nam initiated pilots in three provinces and launched its first HIV self-testing services in August 2016. China also has established pilots to enhance access to HIV self-testing, including delivery of oral self-testing kits combined with blood or urine-based test kits to key populations through community-based organizations. On several university campuses in China, vending machines offer low-cost, urine-based HIV testing kits that can be sent for HIV testing at a quality assured laboratory. Testers can access results anonymously using an app and a unique identifier.

Informal and unregulated sales of self-testing kits through private pharmacies and online retailers in the Region are occurring and will require a public health response. As countries offer HIV self-testing through formal channels, including community-based, facility-based, and Internet-based, WHO recommends a number of considerations, among which are policy and regulatory frameworks that regulate sales to ensure quality and safety of HIV rapid diagnostic tests used for self-testing.

Additional considerations include service delivery approaches that would complement existing HIV testing services and linkages to confirmatory testing and treatment. HIV self-testing requires self-testers with a reactive (positive) result to receive further testing from a trained provider to confirm the result. It is therefore important that self-testers receive clear communication on how to interpret test results and are able to easily access health services for follow-up testing and subsequent treatment, if needed.

Dr Zunyou Wu, director of the National Center for AIDS and Sexually Transmitted Disease Control and Prevention, shares China’s experience, stating: “We have seen online sales of self-testing kits substantially rising, so online platforms such as social networking sites are efficient tools for delivering information and support to self-testers. We are closely monitoring the number of people receiving confirmatory testing to ensure it is at least what we expect based on sales numbers. It is important that HIV-positive individuals are connected to treatment services.”

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