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La autoevaluación del VIH y las pruebas administradas por médicos en el sur de África: una revisión sistemática de
David W Flynn1, Cassandra Fairhead2, Katie Heath3
1School of Public Health, Imperial College London, UK.
AIDS (London, England)
|February 10, 2026
Resumen
La autodiagnóstico del VIH (HIVST) en el sur de África muestra una alta absorción, pero una menor positividad y vinculación con la atención en comparación con las pruebas administradas por el médico. La investigación adicional debe centrarse en mejorar la vinculación con la gestión de la atención para los programas de VIHST.
Área de la Ciencia:
- Salud Pública La salud pública.
- Epidemiología La epidemiología.
- Salud global La salud global.
Sus antecedentes:
- Se estima que 5.3 millones de personas que viven con el VIH (PLHIV) en todo el mundo no eran conscientes de su estado en 2024, con el sur de África enfrentando la mayor carga.
- Comprender los comportamientos y los resultados de las pruebas de VIH es fundamental para las estrategias efectivas de prevención y tratamiento del VIH en las regiones de alta prevalencia.
Objetivo del estudio:
- Para sintetizar la evidencia programática sobre la captación de pruebas de VIH, el rendimiento de positividad y el vínculo con la atención.
- Para comparar los resultados entre las pruebas administradas por el médico y las modalidades de autoevaluación del VIH (HIVST) en el sur de África.
Principales métodos:
- Revisión sistemática de los análisis de resultados a nivel de programa.
- Las búsquedas incluyeron estudios publicados entre 2020-2025 de países del sur de África.
- Se utilizaron coeficientes de probabilidad combinados y modelos lineales generalizados binomiales para analizar la absorción de las pruebas, la positividad y el vínculo con la atención.
Principales resultados:
- Se incluyeron 43 estudios con 290.428 participantes en 8 países del sur de África.
- Los programas de VIHST demostraron una mayor absorción de pruebas (OR = 1.34) pero rendimientos de positividad por VIH más bajos (aOR = 0.63) en comparación con las pruebas administradas por el clínico.
- La vinculación a la atención después de un resultado positivo fue significativamente menor en los programas de VIHST (OR = 0,036).
Conclusiones:
- El VIHST en el sur de África se asocia con una alta absorción de pruebas, pero un rendimiento de positividad reducido y un vínculo con la atención.
- Comparaciones ecológicas y medición de resultados Interpretación del límite de heterogeneidad.
- La investigación futura debe dar prioridad a un vínculo sólido con las estrategias de gestión de la atención para los programas de VIHST.
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