Acceptability and intended usage preferences for six HIV testing options among internet-using men who have sex with men

Abstract

BackgroundMen who have sex with men (MSM) continue to be disproportionately impacted by the Human Immunodeficiency Virus (HIV) epidemic in the United States (US). Testing for HIV is the cornerstone of comprehensive prevention efforts and the gateway to early engagement of infected individuals in medical care. We sought to determine attitudes towards six different HIV testing modalities presented collectively to internet-using MSM and identify which options rank higher than others in terms of intended usage preference.MethodsBetween October and November 2012, we surveyed 973 HIV-negative or -unknown status MSM and assessed their acceptability of each of the following services hypothetically offered free of charge: Testing at a physician’s office; Individual voluntary counseling and testing (VCT); Couples’ HIV counseling and testing (CHCT); Expedited/express testing; Rapid home self-testing using an oral fluid test; Home dried blood spot (DBS) specimen self-collection for laboratory testing. Kruskal-Wallis tests were used to determine whether the stated likelihood of using each of these modalities differed by selected respondent characteristics. Men were also asked to rank these options in order of intended usage preference, and consensual rankings were determined using the modified Borda count (MBC) method.ResultsMost participants reported being extremely likely or somewhat likely to use all HIV testing modalities except DBS self-collection for laboratory testing. Younger MSM indicated greater acceptability for expedited/express testing (P < 0.001), and MSM with lower educational levels reported being more likely to use CHCT (P < 0.001). Non-Hispanic black MSM indicated lower acceptability for VCT (P < 0.001). Rapid home self-testing using an oral fluid test and testing at a physician’s office were the two most preferred options across all demographic and behavioral strata.ConclusionsNovel approaches to increase the frequency of HIV testing among US MSM are urgently needed. Combination testing packages could enable high risk MSM in putting together annual testing strategies personalized to their circumstances, and warrant due consideration as an element of combination HIV prevention packages.

Self-sampling kits to increase HIV testing among black Africans in the UK: the HAUS mixed-methods study

“…The majority of the studies included communities at high risk of HIV infection. Ten studies included MSM, 21,[47][48][49][50][51][52][53]56,57 three included people who inject drugs (PWID) 46,47,50 and three included non-specified individuals or clinic populations who practised high-risk activities. 21,54,55 Only two studies focused on heterosexual populations who practised high-risk activities (both studies were based in the USA); 47,50 all of the UK studies included only MSM.…”

“…NIHR Journals Library www.journalslibrary.nihr.ac.uk The majority of the studies evaluated a dried blood spot SSK (n = 8), 21,46,47,50,[53][54][55]57 whereas five studies assessed an oral fluid test 21,48,49,51,55 (two studies assessed both types of sampling 21,55 and another two did not specify the type of test 52,56 ).…”

“…The methods by which SSKs were distributed varied across the studies, with five studies including the option of kits being mailed out to participants 21,48,49,51,54 and six studies requiring participants to pick up a SSK from a study site 21 (including a pharmacy, 47,54 a drug clinic, 46 a public sex environment 49 and a sauna; 57 the remainder did not specify the method of SSK distribution 50,52,53,55 ). Three studies offered participants a choice of both options 21,49,54 and four studies did not specify how kits were distributed.…”

Comparing Provider and Client Preferences for HIV Prevention Services in South Africa among Men Who Have Sex with Men

“…28,30 An important first step in the development of a combined package of HIV-prevention tools for MSM in South Africa is to determine which prevention tools MSM know, are willing to use, and understand as necessary to protect against HIV. 31 This article presents qualitative data obtained from focus groups of MSM and health service providers recruited in Cape Town and Port Elizabeth, to examine perceptions of the HIV-prevention needs of MSM. The focus is on comparing the perceptions of MSM (the clients) and service providers in order to inform the development of a combined package of HIV prevention tools tailored to the specific needs of MSM and to highlight the public health messaging and training strategies that are needed to successfully implement the package.…”

Perspective on HIV Self-testing in North America: A Tale of Two Countries&mdash;US and Canada

“…For instance, a recent US study in MSM populations in which options to test were offered to study participants reported that home self-tests and testing in physicians' offices were most preferred by them. 32 These studies indicate that because patients prefer home tests, therefore perhaps, improving testing frequency with provision of many self-tests might help offset some of the limitations of these tests in picking up acute HIV infection (at 90 days vs. 30 days or less). Repeat self-testing could be emphasized and highlighted for some sub-populations or individuals with high-risk profiles.…”