Surveying testing preferences in Black, Latin American, and other minorities for the co-design of digital vending machines for HIV self-testing

Abstract

The use of digital vending machines (VMs) to delivery HIV self-testing (HIVST) could expand HIV testing in priority populations. We surveyed primarily Black African (BA) participants and other minority ethnicities, to identify acceptability, preferences, and concerns of using VMs for HIVST dispensing. A structured survey was developed with Black African and Caribbean, Latin American and other Minorities (BLAM) communities, and distributed between September 2018 and January 2019. Participants were recruited using mobile tablet surveys distributed by outreach volunteers, and online through BLAM communities’ websites, workshops, and language-specific messages on social media. Descriptive analyses were undertaken stratified by ethnic groups. One hundred and twenty-eight (67.0%) participants identified as BAs, 31 (16.2%) Black Caribbeans (BCs), 22 (11.5%) Latin Americans (LAs), and 10 (5.2%) other non-white ethnicities (ONWEs). Rates of willingness to use the HIVST were high in all groups except BCs (BAs 77.9%, BCs 53.6%, LAs 81.8%, ONWEs 80.0%). Most participants favoured healthcare-associated venues for VM placement, but there were differences in community venues favoured by different ethnic groups and concerns reported. HIVST is acceptable in many BLAM communities and increases understanding of the concerns and how to address them in the design of VMs for HIVST, to expand HIV testing in these priority communities.

Technology-Delivered Intervention Strategies to Bolster HIV Testing

“…The use of vending machines to dispense HIV self-test kits has been shown to be acceptable and feasible in increasing testing. Investigators have found that dispensing HIV self-test kits in vending machines was acceptable among MSM [ 63 ] and blacks/African American, Hispanic/Latino, and other minorities [ 64 ]. Placement of vending machines may be particularly key in reaching populations at most risk.…”

HIV self-tests for men who have sex with men, accessed via a digital vending machine: a qualitative study of acceptability

“…The placement of an HIVST vending machine in the sexual health clinic waiting room was also found to be acceptable in a survey of 193 black, Latin American and other minority ethnic service users in London. 11 In summary, HIVST vending machines are an acceptable, innovative way to encourage HIV testing. Providers need to ensure this intervention is supported by adequate information regarding the limitation of the test and how to access comprehensive services to avoid any unintended negative effects.…”

“…The placement of an HIVST vending machine in the sexual health clinic waiting room was also found to be acceptable in a survey of 193 black, Latin American and other minority ethnic service users in London. 11…”

“…A pre-implementation survey of minority ethnic groups disproportionately affected by HIV found the majority of those surveyed to be in favour of saunas as a location for HIVST vending machines. 11 It would be prudent to revisit this view with all groups following implementation to ensure support remains. This is particularly important in light of the concern raised by one participant that the placement of an HIVST vending machine in a sauna may in fact increase stigma and prevent others accessing tests this way.…”

“…This has been found to increase first-time and repeat testing 6,7 and to be acceptable to MSM [8][9][10] and other groups disproportionately affected by HIV. 11 It has also helped to overcome barriers to HIV testing including fear of stigmatisation and breach of confidentiality 12 with users placing a high value on the confidentiality and privacy self-testing provides 8 in addition to being more convenient than attending a clinic. 10 Since June 2017, MSM have been able to access HIVST kits for free via a bespoke vending machine located in the foyer of a sauna (a licenced sexon-premises venue).…”