Potential of HIV Self-Sampling to Increase Testing Frequency Among Gay, Bisexual, and Other Men Who Have Sex With Men, and the Role of Online Result Communication: Online Cross-Sectional Study

Abstract

Background Late HIV diagnosis remains frequent among the gay, bisexual, and other men who have sex with men (GBMSM) population across Europe. HIV self-sampling could help remove barriers and facilitate access to testing for this high-risk population. Objective We assessed the capacity of HIV self-sampling to increase the testing frequency among GBMSM living in Denmark, Germany, Greece, Portugal, Romania, and Spain, and evaluated the role of new technologies in the result communication phase. Methods We analyzed a convenience sample of 5019 GBMSM with prior HIV testing experience who were recruited during 2016 through gay dating websites. We estimated the proportion of GBMSM who reported that the availability of self-sampling would result in an increase of their current testing frequency. We constructed a Poisson regression model for each country to calculate prevalence ratios and 95% CIs of factors associated with an increase of testing frequency as a result of self-sampling availability. Results Overall, 59% (between country range 54.2%-77.2%) of the participants considered that they would test more frequently for HIV if self-sampling was available in their country. In the multivariate analysis, the increase of testing frequency as a result of self-sampling availability was independently associated with reporting a higher number of unprotected anal intercourse events in all countries except for Greece. Independent associations were also observed among GBMSM who were not open about their sex life in Germany, Greece, Portugal, and Spain; those with a lower number of previous HIV tests in Denmark, Greece, Portugal, and Spain; and for those that took their last test more than 3 months previously in Germany, Portugal, Romania, and Spain. In addition, 58.4% (range 40.5%-73.6%) of the participants indicated a preference for learning their result through one-way interaction methods, mainly via email (25.6%, range 16.8%-35.2%) and through a secure website (20.3%, range 7.3%-23.7%). Almost two thirds (65%) of GBMSM indicated preferring one of these methods even if the result was reactive. Conclusions Availability of HIV self-sampling kits as an additional testing methodology would lead to a much-needed increase of testing frequency, especially for the hidden, high-risk, and undertested GBMSM population. Online-based technologies without any personal interaction were preferred for the communication of the results, even for reactive results.

HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review

“…Thirty-three studies identified home-based self-testing or self-sampling as the preferred method of testing [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 26 , 29 , 31 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ] ( Table 2 ). Three randomised controlled trials (RCT) found that HIVST increased testing frequency, and therefore was preferred by MSM compared to usual testing [ 17 , 21 , 54 ].…”

“…There was an average use of 3.9 self-tests per person in the free self-testing group over the 15-month period, which was an increase of 1.7 tests per person compared to the testing as usual group [ 17 ]. Another US RCT randomised 65 HIV-negative MSM into three groups: HIVST kits by mail with a follow-up call from a counsellor (eTEST), standard HIVST kits with no follow-up (standard), or letters containing information about HIV testing locations (control) [ 53 ]. Delivery of HIVST kits by post at 3-month intervals increased testing, with all participants from the eTEST and standard groups testing at least once during the 7-month period compared to 72% of the control group.…”

“…Delivery of HIVST kits by post at 3-month intervals increased testing, with all participants from the eTEST and standard groups testing at least once during the 7-month period compared to 72% of the control group. There was also nearly double the rate of repeat testing amongst these intervention groups [ 53 ]. The last RCT, conducted in Australia, randomised 362 men to free HIV self-testing plus facility-based testing, or facility-based testing only.…”

Geografia dezvoltării. Abordări centrate pe om

“…Le Roux (2017) discută despre implicarea actorilor religioși în educarea cu privire la HIV în țări cu prevalență scăzută (Rusia, Armenia și România). Chestionând un eșantion de homosexuali, bisexuali, și alți bărbați care întrețin relații sexuale cu bărbați (GBMSM), din șase țări europene, inclusiv România, Maté et al (2020) propun o metodă de testare personală pentru HIV. Manolescu et al (2019) atrag atenția asupra pericolului indus de sifilis asupra femeilor însărcinate din România și a nou-născuților acestora.…”

Intention to use and acceptability of home-based sexual health care among men who have sex with men who previously attended clinic-based sexual health care

“…Home-based sexual health care consists of self-collection of samples, and additional online sexual health counseling, for example about PrEP and chemsex. Home-based alternatives for testing can overcome perceived and experienced barriers among MSM for STI/HIV testing at STI clinics such as privacy, confidentiality, and time-constraints ( 9 , 10 ). Home-based care options enable continual access to care for MSM who seek sexual health care, and due to COVID-19 restrictions, personal needs, or other reasons, experience barriers to clinic-based testing or sexual health counseling.…”