HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women

Abstract

HIV status awareness is key to prevention, linkage-to-care and treatment. Our study evaluated the accessibility and potential willingness of HIV self-testing among men who have sex with men (MSM) and transgender women in Peru. We surveyed four pharmacy chains in Peru to ascertain the commercial availability of the oral HIV self-test. The pharmacies surveyed confirmed that HIV self-test kits were available; however, those available were not intended for individual use, but for clinician use. We interviewed 147 MSM and 45 transgender women; nearly all (82%) reported willingness to perform the oral HIV self-test. However, only 55% of participants would definitely seek a confirmatory test in a clinic after an HIV-positive test result. Further, price may be a barrier, as HIV self-test kits were available for 18 USD, and MSM and transgender women were only willing to pay an average of 5 USD. HIV self-testing may facilitate increased access to HIV testing among some MSM/transgender women in Peru. However, price may prevent use, and poor uptake of confirmatory testing may limit linkage to HIV treatment and care.

Addressing Missed Opportunities for HIV Testing by Including Rapid HIV Self-testing Kits with Patient-Delivered Partner Therapy

“…Interview data provided rationale for why STI clinic patients might be willing to deliver HIVST kits to their partners with PDPT, which could help facilitate disruption of STI and HIV transmission if implemented with favorable uptake. This data supports a growing body of evidence supporting the acceptability of HIVST (Ahmed-Little et al, 2016; Bavinton et al, 2013; Bustamante et al, 2017; Choko et al, 2015; Gaydos et al, 2011; Kelvin et al, 2016; Kurth et al, 2016; Lee, Brooks, Bolan, & Flynn, 2013; Pal et al, 2016; Prestage et al, 2016; Witzel, Rodger, Burns, Rhodes, & Weatherburn, 2016). Moreover, this research adds to prior data on the acceptability of secondary distribution of HIVST kits to sexual partners (Kalibala et al, 2014; Lippman et al, 2016; Masters et al, 2016; Prestage et al, 2016; Thirumurthy et al, 2016), indicating rationale for why individuals might find it acceptable.…”

Prevalence and Correlates of HIV Infection and HIV Testing Among Transgender Women in Jamaica

“…There is a growing body of literature that suggests that HIV self-testing, administered in a location of an individual's choosing, is acceptable to transgender women and may address concerns with privacy, confidentiality, and stigma (HIV-related, transgender) often encountered by transgender women in the context of clinic-based HIV testing. [42][43][44] However, in the absence of structural interventions to address stigma in healthcare settings, transgender women living with HIV may continue to experience barriers accessing the HIV care continuum. 42 HIV positive participants were 6-fold more likely to be homeless, and a history of incarceration was associated with substantially (>70%) reduced odds of ever receiving an HIV test.…”

New HIV testing technologies in the context of a concentrated epidemic and evolving HIV prevention: qualitative research on HIV self‐testing among men who have sex with men and transgender women in Yangon, Myanmar

“…Research on the feasibility and acceptability of HIVST among MSM and TW has predominantly originated from Europe and the U.S., where self-testing has been approved and available over-the-counter since 2012 [11]. Some studies have recently been reported from the Latin American and sub-Saharan African regions, as well as China and Cambodia [18][19][20]. A review on the acceptability and feasibility of self-testing among key populations has found general acceptance of HIVST among MSM, particularly noting convenience and privacy of testing [18].…”