A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men

Abstract

BackgroundMen who have sex with men (MSM), particularly MSM who identify as African-American or Black (BMSM), are the sociodemographic group that is most heavily burdened by the human immunodeficiency virus (HIV) epidemic in the United States. To meet national HIV testing goals, there must be a greater emphasis on novel ways to promote and deliver HIV testing to MSM. Obstacles to standard, clinic-based HIV testing include concerns about stigmatization or recognition at in-person testing sites, as well as the inability to access a testing site due to logistical barriers.ObjectiveThis study examined the feasibility of self-administered, at-home HIV testing with Web-based peer counseling to MSM by using an interactive video chatting method. The aims of this study were to (1) determine whether individuals would participate in at-home HIV testing with video chat–based test counseling with a peer counselor, (2) address logistical barriers to HIV testing that individuals who report risk for HIV transmission may experience, and (3) reduce anticipated HIV stigma, a primary psychosocial barrier to HIV testing. MethodsIn response to the gap in HIV testing, a pilot study was developed and implemented via mailed, at-home HIV test kits, accompanied by HIV counseling with a peer counselor via video chat. A total of 20 MSM were enrolled in this test of concept study, 80% of whom identified as BMSM.ResultsAll participants reported that at-home HIV testing with a peer counseling via video chat was a satisfying experience. The majority of participants (13/18, 72%) said they would prefer for their next HIV testing and counseling experience to be at home with Web-based video chat peer counseling, as opposed to testing in an office or clinic setting. Participants were less likely to report logistical and emotional barriers to HIV testing at the 6-week and 3-month follow-ups.ConclusionsThe results of this study suggest that self-administered HIV testing with Web-based peer counseling is feasible and that MSM find it to be a satisfactory means by which they can access their test results. This study can serve as a general guideline for future, larger-scale studies of Web-based HIV test counseling for MSM.

Using technology to support HIV self-testing among MSM

“…Approaches focused primarily on HST kit distribution address key overall HIV testing barriers such convenience, confidentiality, and stigma; however, in general they only address HST concerns related to cost and access. In contrast, completed [27**, 28**, 29, 30*] or ongoing studies (Table 1) that provide free HST as part of comprehensive HIV prevention interventions or interventions designed to support HST performance have the added advantage of addressing general HIV testing barriers as well as a greater number of HST-specific concerns such as a lack of pre- and post-test counseling, user error, and misinterpretation of results. Importantly, these interventions actively facilitate linkage to HIV care or prevention and thus may have greater potential to curb epidemics among MSM by increasing the likelihood of antiretroviral therapy uptake (for treatment or prevention) and repeat testing.…”

“…Two published articles and one funded study describe interventions that use videoconferencing to provide counseling to MSM during the HST process. Maksut and colleagues assessed the feasibility of providing peer-based counseling via video chat to YMSM conducting HST [28**]. The US-based study enrolled 20 YMSM, 80% of whom were Black YMSM.…”

Assessment of HIV prevalence among MSM in Tokyo using self-collected dried blood spots delivered through the postal service

“…However, when this program is expanded nationwide, it will be difficult to include counselors at all HIV testing kit distribution sites. Other counseling methods, such as live-chat consultation on the website [ 14 ] or telephone counseling would be necessary.…”

Perceptions of HIV Self-Testing Among Men Who Have Sex With Men in the United States: A Qualitative Analysis

“…Conversely, an in-home rapid HIV test could provide the opportunity to reach persons who have never tested for HIV or those who test infrequently, empower users to test on their own, normalize screening, and facilitate partner testing (Myers et al, 2013;Wood et al, 2014). Recent studies provide support for the oral fluid in-home rapid HIV test, indicating that MSM have a preference for using an oral swab compared to blood-based tests, and that it is highly acceptable among MSM when accompanied with peer support (Maksut, Eaton, Siembida, Driffin, & Baldwin, 2016;Mitchell & Sullivan, 2015;Sharma, Stephenson, White, & Sullivan, 2014). Although concerns remain (Myers et al, 2013;Wood et al, 2014), the increasing acceptability and willingness of highrisk populations to use HIVST warrants a better understanding of their perceptions (positive and negative) regarding this approach (Carballo-Diéguez, Frasca, Balan, Ibitoye, & Dolezal, 2012;Figueroa, Johnson, Verster, & Baggaley, 2015;Lippman et al, 2016;Schnall, John, & Carballo-Dieguez, 2016).…”