Assessment of HIV prevalence among MSM in Tokyo using self-collected dried blood spots delivered through the postal service

Abstract

BackgroundMen who have sex with men (MSM) are at high risk of HIV infection. However, there are only few data on HIV prevalence in MSM in Japan. The objective of this study was to explore the HIV prevalence in MSM at Shinjuku 2-chome, a well known gay quarter in Tokyo.MethodsMSM directly collected the dried blood spot (DBS) self-collection HIV test kit from a drop-in center in Shinjuku 2-chome between August 2015 and December 2016. The participants collected their own blood by finger-prick and anonymously posted the kit to the laboratory. The participants accessed the study website and checked the results of their tests using unique ID and password. DBS was soaked in phosphate buffered saline overnight and the eluted sample was examined by the fourth generation HIV Ag/Ab test of LUMIPULSE (FUJIREBIO INC.), and followed by HISCL (Sysmex Corp.) when the first assay was positive. The result was defined provisionally positive if both were positive.ResultsA total of 1702 HIV test kits were distributed and 1403 DBS were returned (return rate: 82.4%). Since 20.2% of participants collected the test kit more than once, the estimated number of actual test kit users was 1120. Based on the results of the test kit, 34 cases were provisionally diagnosed with HIV. The estimated prevalence was 3.04% (95% confidence interval: 2.03–4.04). Of these 34, 24 (70.6%) were later confirmed to be HIV-positive in the hospital, while the remaining 10 were lost to follow-up. Among the participants, 34.5% received HIV test for the first time. Especially in those aged 20–29, 46.0% were first time HIV testers.ConclusionsThe prevalence of HIV infection in the study population was 3.04%. The high collection suggested a demand for this type of testing in MSM. The test should be expanded further to difficult-to-reach or hidden populations.Trial registrationThis study was registered with the University Hospital Medical Information Network Clinical Trial Registry in August 20th, 2015 (Registry number: UMIN000018699).Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3491-0) contains supplementary material, which is available to authorized users.

The feasibility of modified HIV and antiretroviral drug testing using self-collected dried blood spots from men who have sex with men

“…Most MSM followed the DBS collection and packaging/mailing instructions to provide their own specimens for HIV laboratory-based testing. Our analyses support the self-collection and mailing of DBS as a possible strategy for collecting blood specimens from MSM for HIV testing and treatment monitoring [ 14 , 15 ].…”

Dried blood spot self-sampling at home is a feasible technique for hepatitis C RNA detection

“…A home sampling testing service may lower barriers to testing, increase testing frequency and thus limit onward transmission. Takano et al showed that ssDBS for HIV testing is an acceptable method for MSM in Tokyo and can improve access to testing for MSM who live in rural areas [21]. Coats and Dillon found evidence that DBS may increase the frequency of HCV testing [30].…”

“…The majority of these studies reported the use of ssDBS for determining drug levels [16][17][18][19]. One large Japanese study showed the successful use of ssDBS sent by regular mail for HIV diagnosing HIV using an HIV antigen/antibody test [21].…”

Screening for Human Immunodeficiency Virus Infection by Use of a Fourth-Generation Antigen/Antibody Assay and Dried Blood Spots: In-Depth Analysis of Sensitivity and Performance Assessment in a Cross-Sectional Study

“…The minimal invasiveness of sampling and the ease of handling, storing, and transporting DBS offer additional opportunities to reach the first 90% of the 90-90-90 UNAIDS target. This strategy can be applied to highly diverse contexts, including, for instance, the testing of self-collected DBS delivered through the postal service (35,36).…”