Introduction
HIV testing coverage remains low among men who have sex with men (MSM) and transgender women (TGW). We studied characteristics of Thai MSM and TGW who chose online and/or offline platforms for HIV counselling and testing and the feasibility of integrating online technologies and HIV selfâtesting to create service options.MethodsFrom December 2015 to June 2017, MSM and TGW enrolled from Bangkok Metropolitan Region and Pattaya could choose between: 1 offline HIV counselling and testing (Offline group), 2 online preâtest counselling and offline HIV testing (Mixed group), and 3 online counselling and online, supervised, HIV selfâtesting (Online group). Sociodemographic data, risk behaviour and social network use characteristics were collected by selfâadministered questionnaires. Logistic regression models identified covariates for service preferences.ResultsOf 472 MSM and 99 TGW enrolled, 202 selfâselected the Offline group, 158 preferred the Mixed group, and 211 chose the Online group. The Online group had the highest proportion of firstâtime testers (47.3% vs. 42.4% vs. 18.1%, p < 0.001) and reported highest HIV prevalence (15.9% vs. 13.0% vs. 3.4%, p = 0.001) as compared to Offline and Mixed groups, respectively. Having tested for HIV twice or more (OR 2.57, 95% CI 1.03 to 6.41, p = 0.04) increased the likelihood to choose online preâtest counselling. Being TGW (OR 6.66, 95% CI 2.91 to 15.25, p < 0.001) and using social media from four to eight hours (OR 2.82, 95% CI 1.48 to 5.37, p = 0.002) or >8 hours (OR 2.33, 95% CI 1.05 to 5.16, p = 0.04) increased selection of online, supervised, HIV selfâtesting. Providers primarily used smartphones (79.2%) and laptops (37.5%) to deliver online services. Selfâtesting strip image sharpness and colour quality were rated âgoodâ to âexcellentâ by all providers. Most participants (95.1%) agreed that online supervision and HIV selfâtesting guidance offered were satisfactory and well delivered.ConclusionsOnline HIV services among MSM and TGW are feasible in Thailand and have the potential to engage high proportions of firstâtime testers and those with high HIV prevalence. When designing public health interventions, integrating varied levels of online HIV services are vital to engage specific sections of MSM and TGW populations in HIV services.Clinical Trial NumberNCT03203265