| BackgroundIn our country,the government distributed the health resources according to the density distribution of the population,and also used the ownership of the per capita health resources to evaluate the allocation level of the health resources in the region.The health policy was also based on the index of percapita such as the number of doctors per thousand population.The geographical situation and the accessibility of health services are extremely uneven.Until recently,the relevant government departments have gradually realized that the geographical area,economic level and other factors should also be formulated as a policy specification.Guangxi Province,located on the border,is China’s economically underdeveloped areas.,The number of HIV/AIDS patients of Guangxi Province is increasing and second only to Yunnan Province.HIV infection/AIDS patients bring the high cost of health resources,and also bring pressure for the government on reasonable allocation of health resources.HIV self-help sampling package is a new attempt for the existing detection mode,it can not only protect the privacy of the person being tested,but also to a certain extent reduced due to remote,because the lack of health services.The incidence of AIDS is increasing,resulting in the spread of AIDS.In these remote areas,the main medium of AIDS infection is low-grade sex workers.Low-grade sex workers self-protect awareness of the risk is poor,high frequency of commercial sexual behavior,low fees,the mobility of such people is high.The frequency of test is low,it is more likely to lead to the spread of AIDS in the local scope.In 1996,the United States began to carry out the mail delivery detection mode that dry blood spots(Dried blood spots,DBS)as the carrier of the sample.The(Dried blood spots)can be collected at home by the subjects,and then mail it to the professional laboratory to test,and finally,the subjects can obtain the results by telephone and referral service.So far,has proved to be a good complement to the traditional detection model,besides,the performance in high-risk groups and remote areas of AIDS is particularly prominent.ObjectiveTo investigate the level of the cognitive and the willingness of Self-help Sampling Packet in female sex workers.Objects and MethodsFemale sex workers were recruited in the Guangxi Zhuang Autonomous Region to carry out a questionnaire survey to understand their awareness of AIDS self-help sampling package and their intention to use.ResultsGeneral demographic characteristics:Among the 293 female sex workers who participated in the survey,82.59%of the whole population is 20 to 40 years old,206(70.31%)have received HIV testing,and the floating population accounted for 45.05%.The awareness of self-help sampling package:234 people(79.86%)heard of self-help sampling package,of which the information of the 167 people from the doctor,70 people from the outreach project,1 people from science knowledge;Logistic regression analysis showed that the people who have received HIV testing have a greater awareness of the self-help sampling package(P<0.001,OR = 17.265),and the doctor’s missionary had a positive effect on the awareness of the self-help sampling(P = 0.1458,OR = 2.449),the factors that participate in the outreach program have a certain effect on the self-help sampling(P = 0.1458,OR = 2.449),age factor and HIV self-sampling package were statistically relevant and it’s OR values were all bigger than 1;the willingness to use the self-sampling package:After high risk behavior,there are only 0.68%of the people in the investigation choose the self-sampling method for HIV infection detection,compared Under the PITC and VCT,it’s Selection rate are up to 61.09%,36.86%;the willingness of sending the sample:16.72%of people choose to self-deliver;only 7.85%of people choose to mail;The willingness of inquiring of the results and counseling services:77.13%of the people willing to obtain test results by telephone,88.05%of the people willing to obtain the consultation services by telephone,the proportion of the people who willing to believe the accurateness of the self-sampling test results to 82.59%;Factors that affect the use of the package of the self-sampling:the people who clearly expressed that do not know accounted for 57%,feel inconvenient accounted for 7.51%,suspect the accuracy of the results accounted for 1.71%,do not know how to operate accounted for 3.41%,feel easily polluted accounted for 7.17%.ConclusionsThe level of the cognitive HIV Self-help Sampling Packet in the female sex workers need to be improved,the female sex workers are lack of willingness to use the HIV Self-help Sampling Packet.If the self-sampling package would be promoted,greater publicity is an effective way to promote its use.BackgroundThe Centers for Disease Control and Prevention(CDC)of USA,has proposed a test procedure for detection of HIV for the patients who are older than 24 months in 2014.At the beginning of the procedure,the fourth generation of antigen antibody detection reagents is used for screening.The negative results can be directly reported if the result is no response,or it will need to carry out HIV-1/HIV-2 antibody differentiation experiments.HIV-1/HIV-2 antibody differentiation experiments were no response or were indeterminate,and HIV nucleic acid qualitative tests were carried out.This procedure helps to improve HIV-2 detection rate,also helps to find samples in the window period.In 2015,the recommended HIV screening methods in China’s HIV testing technology include enzyme-linked immunosorbent assays,HIV rapid test,chemiluminescence,and immunoluminescence.The WB test,linear WB test and so on as a confirmation method.In the detection strategy for the purpose of diagnosis,the first screening reagent is used to do the screening test,no response can be reported negative,or it needs to use the original reagent and another different manufacturers(or different principles)of the reagent,or other Two different principles or manufacturers of reagents for re-examination.Both of the results are negative can be reported negative,otherwise it will be confirmed by the confirmation method.The additional experiments were carried out when its result of the Confirmation of experimental is uncertain.In this study,HIV self-sampling kit was used to combine HIV rapid detection with dry blood spot sample antibody detection.it proposes a new detection model to prefect our country’s HIV testing strategy.Objective1.To evaluate the efficiency of the antibody detection by dry blood spot samples.2.To assess the detection model through the field application of HIV self-sampling package.MethodsFirst of all,according to the recommendations of the literature and related experts put forward a use of HIV self-sampling package for the innovative point of the new test mode.HIV self-sampling package includes:disposable blood collection needle,disposable medical alcohol swab,Band-Aid,HIV-1/2 rapid detection reagent,buffer,blood collection card(filter paper),instruction manual,the envelope marked with the address.In this study,we conducted the collection and recycling of HIV self-help packages in a group and peer education manner.At first,we trained the group leader and peer education contact person.At the scene,under the guidance of the team leader and peer education contact person,the subjects were tested by HIV rapid detection reagent and the results were interpreted,at the same time,samples of dry blood spots were made.Finally,the samples of the blood samples were sent to the professional laboratory by the envelope with the address of the sampling package.The enzyme-linked immunosorbent assay and the nucleic acid qualitative test will be do by the professional laboratory.The evaluation process is divided into retrospective evaluation stage and prospective evaluation stage.The retrospective evaluation stage mainly uses the existing samples of the laboratory to evaluate the test methods to be used in this study to evaluate whether the detection efficiency meets the research needs.The prospective evaluation phase mainly applies the detection strategy proposed in this study to the region and the crowd which is expected to assess the detection efficiency of the actual application in order to explore whether it can meet the real needs.ResultsRetrospective evaluation stage,the dry blood spot samples which it’s status is known were used for evaluating the methods of anti-body detection.The coincidence rate of the healthy population was 98.47%(257/261),the Kappa consistency coefficient was 0.66;The coincidence rate of the MSM population was 100%,the Kappa consistency coefficient wasl;The coincidence rate of the healthy population was 98.80%(247/250),the Kappa consistency coefficient was 0.97;The coincidence rate of the total sample was 99.13%(800/807);the Kappa consistency coefficient of the high risk population was 0.98.In the prospective evaluation stage,the sensitivity of HIV detection was 90.48%and the specificity was 100%using the rapid detection reagent in HIV self-sampling kit in Guangxi.In this study,two cases of WB test were found to be uncertain,Nucleic acid qualitative detection was positive;the use of dry blood spot samples for HIV enzyme-linked immunosorbent assay,the sensitivity of 100%,specificity of 100%;the coincidence rate of the results of HIV rapid detection and the results of the antibody which is detected by the dry blood spots is 98.95%,and it’s Kappa coherence coefficient was 0.9442.The coincidence rate of HIV WB test and nucleic acid qualitative test was 96.33%and the Kappa coherence coefficient was 0.8507.In Hunan scene,The sensitivity of HIV rapid detection in HIV self-sampling kit was 66.67%and the specificity was 98.30%.The sensitivity of HIV-linked immunosorbent assay was 73.33%,the specificity was 98.30%.The coincidence rate of HIV rapid test results and antibody detection using dry blood spot was 97.30%and the Kappa consistency coefficient was 0.85.Conclusions1.Laboratory retrospective evaluation of the use of dry blood samples for HIV antibody testing,the results show that both in the health population or high-risk groups have a good detection efficiency,it can meet the requirements of experimental testing.2.In the process of prospective evaluation,it is found that the detection model of this study is a novel alternative strategy which takes the detection efficiency and cost-effectiveness into account.Besides,it also helps to improve the detection rate of early infection. |
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