Attitude and Behavior Changes Among Gay and Bisexual Men After Use of Rapid Home HIV Tests to Screen Sexual Partners

Abstract

HIV testing can now be self-administered outside clinical settings through the purchase of home testing (HT) kits. Individuals also can use the kits to perform a test on a potential sexual partner prior to intercourse. We provided a three-month supply of HT kits to men who reported multiple male partners and little or no condom use for anal intercourse. Participants used the test kits with partners in over 100 occasions. At the end of the study, approximately half of the participants described shifts in their attitudes and/or behaviors related to sexual risk. Reported changes included increased awareness of risk, increased discussion of STI/HIV safety measures, changes in partner choice and heightened consciousness of partner thinking. Easy access to HT kits may be a risk-reduction strategy for men with a high risk profile because their regular use could have an impact beyond the specific sexual encounter.

Anticipated and Actual Reactions to Receiving HIV Positive Results Through Self-Testing Among Gay and Bisexual Men

“…To provide the most effective combination of proven behavioral and biomedical approaches for those who are not infected but are at highest risk for HIV, self-testing appears to be a feasible approach to increase testing and reduce risky behaviors [11, 21]. The HIV self-testing tool empowered this specific group of gay and bisexual men who engage in risky sexual behavior to test themselves and their partners and know their status.…”

“…Some researchers believe that use of the HIV self-testing kit could empower individuals to manage their HIV risks, help couples make informed decisions before engaging in sexual activities, and address three important barriers to testing: stigma, convenience and privacy [9-11]. However, others have expressed concerns about the potential drawbacks of self-testing including: lack of counseling and referral to care [12], misinterpretation of the test results [13], failure to detect cases of acute HIV infection due to the test’s window period [14], ethical issues involved in testing partners prior to sex [15], and the psychological impact of receiving a positive result in a non-clinical setting [16].…”

Perspective on HIV Self-testing in North America: A Tale of Two Countries—US and Canada

“…Any individual contemplating the purchase of a self-test goes through the process of behavior change that includes a pre-cognition phase and cognition phase, followed by an action phase (which leads to the purchase of the self-test). 16 Likewise, the process of selftesting toward a diagnosis (with a positive or negative result) is also complex. This process entails accurately understanding the self-test instructions, conducting the self-test correctly, and interpreting the test results accurately.…”

HIV-Negative Partnered Men’s Attitudes Toward Using an In-Home Rapid HIV Test and Associated Factors Among a Sample of US HIV-Negative and HIV-Discordant Male Couples

“…Recent studies have examined men’s willingness to use an HT, whether they would use an HT to screen potential sexual partners, and how their use of an HT impacts their engagement in UAS, and changes in their attitudes and behaviors related to sexual risk for HIV infection [23–29]. In one US study prior to HT becoming available for over-the-counter sale, over 80% of MSM said they would use a HT to self-test themselves and/or sexual partners [25].…”

“…In total, participants reported 10 positive test results: 6 were unaware of their positive serostatus, 7 were potential sex partners, and 3 were acquaintances of the study participants [28]. For some participants, the use of an HT to screen potential sex partners helped to heighten their awareness of, and commitment to, reducing their risk for HIV [29]. The men also reported being able to use the HT in both private and public spaces with little to no problems, and had a strong desire to continue to use HTs with a willingness to buy them [28].…”