학술논문

Health, harm reduction, and social service providers’ perspectives on the appropriateness and feasibility of peer distribution of HIV self-test kits among people who use drugs
Document Type
article
Source
Harm Reduction Journal. 21(1)
Subject
Health Services and Systems
Public Health
Health Sciences
Substance Misuse
Health Services
Drug Abuse (NIDA only)
HIV/AIDS
Clinical Research
Humans
Harm Reduction
Self-Testing
Pharmaceutical Preparations
Feasibility Studies
HIV Infections
People who inject drugs
HIV self-testing
Secondary distribution
Social networks
HIV prevention
Harm reduction
Public Health and Health Services
Substance Abuse
Health services and systems
Public health
Language
Abstract
BackgroundPeople who use drugs (PWUD) experience elevated HIV risk and numerous barriers to facility-based HIV testing. HIV self-testing (HIVST) could circumvent many of those barriers and is acceptable among PWUD, yet HIVST implementation for PWUD is limited. Service providers' perspectives on specific HIVST delivery strategies could help increase availability for PWUD.MethodsFrom April-November 2021, we interviewed 16 health, harm reduction, and social service providers working with PWUD in San Diego, CA. Interviews and rapid thematic analysis explored perspectives on HIVST's utility and appropriateness, as well as the feasibility of and anticipated challenges with specific HIVST delivery strategies, including peer or secondary distribution.ResultsParticipants viewed HIV as a significant threat to PWUD health and confirmed the presence of numerous barriers to local facility-based HIV testing. Participants viewed HIVST as a promising and potentially empowering solution. Based on community familiarity with secondary distribution of harm reduction supplies (i.e., naloxone) and information, participants viewed secondary distribution of HIVST kits as an appropriate and feasible strategy for increasing the reach of HIVST, but also described potential barriers (e.g., engaging socially disconnected individuals, ensuring linkages to services following HIVST) and provided suggestions for alternative HIVST kit delivery models (e.g., harm reduction vending machines).ConclusionsService providers viewed secondary distribution of HIVST kits among PWUD as promising, appropriate, and feasible, yet specialized efforts may be needed to reach the most marginalized individuals and ensure consistent provision of educational information and referral supports that maximize the impact of this approach.