Preparedness for use of the rapid result HIV self‐test by gay men and other men who have sex with men (MSM): a mixed methods exploratory study among MSM and those involved in HIV prevention and care

Abstract

ObjectivesThe aim of the study was to explore preparedness for the HIV self‐test among men who have sex with men (MSM) and those involved in HIV prevention and care.MethodsA mixed methods exploratory research design was employed, detailing awareness and willingness to use the self‐test and the perceived barriers and facilitators to implementation. Quantitative and qualitative data collection and analysis were completed in parallel. Descriptive and inferential analysis of cross‐sectional bar‐based survey data collected from MSM through a self‐completed questionnaire and oral fluid specimen collection (n = 999) was combined with qualitative, thematic, analysis of data collected through 12 expert focus groups (n = 55) consisting of gay men, National Health Service (NHS) staff, community organizations, entrepreneurs and activists. Findings were subsequently combined and assessed for synergies.ResultsAmong MSM, self‐test awareness was moderate (55%). Greater awareness was associated with increased educational attainment [adjusted odds ratio 1.51; 95% confidence interval (CI) 1.00–2.30; P = 0.05] and previous history of sexually transmitted infection (STI) testing (adjusted odds ratio 1.63; 95% CI 1.11–2.39; P = 0.01). Willingness to use the test was high (89%) and associated with meeting sexual partners online (unadjusted odds ratio 1.96; 95% CI 1.31–2.94; P < 0.001). Experts highlighted the overall acceptability of self‐testing; it was understood as convenient, discreet, accessible, and with a low burden to services. However, some ambivalence towards self‐testing was reported; it could reduce opportunities to engage with wider services, wider health issues and the determinants of risk.ConclusionsSelf‐testing represents an opportunity to reduce barriers to HIV testing and enhance prevention and access to care. Levels of awareness are moderate but willingness to use is high. Self‐testing may amplify health inequalities.

Linkages to HIV confirmatory testing and antiretroviral therapy after online, supervised, HIV self‐testing among Thai men who have sex with men and transgender women

“…Diverse approaches to HIV testing for people with various testing experience and risk perception are needed to maximize its public health benefit . To end HIV by 2030, Thailand needs to urgently adopt and scale‐up various HIV testing service delivery models.…”

New initiatives to develop self-testing for HIV

“…Confidentiality, convenience, immediacy and the opportunity to increase testing frequency are commonly cited benefits of HIVST (22)(23)(24)(25)(29)(30)(31)(32). Barriers tend to be concerns around dislocation from care pathways, the possibility of coercive testing practices, and perceived issues with selfefficacy as well as kit accuracy (31,33,34).…”

The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development

“…With changes in legislation in April 2015, instant-result home HIV infection testing is now possible, with tests delivered via the internet or purchased over the counter and results available within a few minutes to the person testing. 25 Equally, HIV self-sampling has become relatively commonplace and has high acceptability; samples are self-collected and returned for laboratory-based testing, with the results given to individuals at a later date. 26,27 Test results are often delivered electronically using mobile phone technology for non-reactive results and recalling those people with reactive test results for further testing.…”