Coercion and HIV Self-Testing in Men Who Have Sex With Men: Implementation Data From a Cross-Sectional Survey in China

Ong, Jason J.; Li, Haochu; Wu, Dan; Fu, Hongyun; Liu, Ewen; Ma, Wei; Kang, Dianmin; Liao, Meizhen; Marley, Gifty; Wei, Chongyi; Tang, Weiming; Pan, Stephen W.; Liu, Chuncheng; Desmond, Nicola; Yang, Bin; Yang, Ligang; Huang, Shujie; Tucker, Joseph D.

doi:10.1097/qai.0000000000001583

Cited by 14 publications

(9 citation statements)

References 17 publications

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“…It is also a relevant finding as one concern regarding HIVST has been the possibility of a decrease in STI testing, even though the evidence concerning this has been inconclusive [ 12–14 ]. Thus, it is important to further evaluate the potential impact of HIVST on STI testing in different contexts, along with other concerns such as HIVST not being used as intended to test oneself, but to screen potential sex partners, HIVST decreasing condom use, and HIVST increasing the risk of coerced HIV testing [ 7 , 14 , 47 ]. The potential concerns of medical, social, and psychological harm as well as ethical and legal issues underscore the need for policies, regulatory frameworks, and monitoring.…”

Section: Discussionmentioning

confidence: 99%

HIV self-testing for men who have sex with men in Sweden. A cross-sectional study concerning interest to use HIV self-tests

Kinnman

Herder

Björkman

et al. 2022

Global Health Action

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Background HIV self-testing (HIVST) has been found to have high acceptability among men who have sex with men (MSM) internationally and might contribute to increase testing frequencies, but many countries, including Sweden, lack policies for using HIVST. Objective To examine interest to use and willingness to pay for HIVST, and associated factors, among MSM attending HIV testing venues in Sweden. Method This cross-sectional study analyzed data from a self-administered survey, consisting of 33 questions, collected at six HIV testing venues in Sweden in 2018. The sample consisted of sexually active men who have sex with men, aged ≥ 18 years, and not diagnosed with HIV. Data were analyzed descriptively and by univariable and multivariable logistic regression. Result Among 663 participants (median age 33 years), 436 respondents (65.8%) expressed interest to use HIVST. Among those interested, less than half, 205 (47.0%), were willing to pay for HIVST. Being interested in HIVST was found to be negatively associated with being in the 55 years or older age group (AOR 0.31, CI 0.14–0.71), and having had syphilis, rectal chlamydia, or rectal gonorrhea in the preceding 12 months (AOR 0.56, CI 0.32–0.99). In the sample of MSM interested in HIVST, willingness to pay was positively associated with being in the age groups 35–44 years (AOR 2.94, CI 1.40–6.21), 45–54 years (AOR 2.82, CI 1.16–6.90), and 55 years or above (AOR 3.90, CI 1.19–12.81), and negatively associated with being single (AOR 0.56, CI 0.36–0.88). Conclusion This study found high interest for HIVST in a sample of MSM in Sweden. However, HIVST offered at a cost is likely to negatively affect uptake among MSM broadly, compared with free availability.

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Section: Discussionmentioning

confidence: 99%

HIV self-testing for men who have sex with men in Sweden. A cross-sectional study concerning interest to use HIV self-tests

Kinnman

Herder

Björkman

et al. 2022

Global Health Action

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“…However, we noted that HIV testing programs often emphasized the clinical urgency of testing, as well as, target achievement while paying little attention to contextual and individual factors [ 45 ]. We recommend that HIVST delivery program implementers aim for context-specific and individualized strategies to encourage individuals to test and seek post-test services thereby avoiding inadvertent coercive testing associated with non-facility HIVST testing models [ 46 ]. This can provide a supportive and trusted environment for a broader tester buy-in among suboptimal testers.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a campus-based and peer-delivered HIV self-testing intervention to improve the uptake of HIV testing services among university students in Zimbabwe: the SAYS initiative

Mukora-Mutseyekwa

Mundagowa

Kangwende

et al. 2022

BMC Health Serv Res

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Background The uptake of HIV testing services among adolescents and young adults in Zimbabwe is low due to stigma associated with the risk of mental and social harm. The WHO recommends HIV self-testing (HIVST) as an innovative approach to improve access to HIV testing for this hard-to-reach populations. This study describes the development and implementation of a coordinated multifaceted and multidisciplinary campus-based approach to improve the uptake of HIV testing among university students in Zimbabwe. Methods We utilized both quantitative and qualitative methods guided by the Exploration, Preparation, Implementation, and Sustainment Framework. A formative survey, in-depth interviews, and a scoping review were conducted as part of the situation analysis. Implementers (peer educators and health workers) were trained and community dialogue sessions were conducted to ascertain the determinants (enablers and barriers) influencing both the inner and outer contexts. Self-test kits were disbursed over 6 months before a summative evaluation survey was conducted. Qualitative data were analyzed thematically while the chi-squared test was used to analyze quantitative data. Results The formative evaluation showed that 66% of students intended to test and 44% of the enrolled students collected HIVST test kits. Giving comprehensive and tailored information about the intervention was imperative to dispel the initial skepticism among students. Youth-friendly and language-specific packaging of program materials accommodated the students. Despite the high acceptability of the HIVST intervention, post-test services were poorly utilized due to the small and isolated nature of the university community. Implementers recommended that the students seek post-test services off-site to ensure that those with reactive results are linked to treatment and care. Conclusions Peer-delivered HIVST using trained personnel was acceptable among adolescents and young adults offered the intervention at a campus setting. HIVST could increase the uptake of HIV testing for this population given the stigma associated with facility-based HTS and the need for routine HIV testing for this age group who may not otherwise test. An off-site post-test counseling option is likely to improve the implementation of a campus-based HIVST and close the linkage to treatment and care gap.

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“…Other studies also raised concerns on HIVST, particularly whether postcounselling after testing should be done face-to-face to not exacerbate negative behaviours and unfavourable consequences. 49 50 Reservations on HIVST have also been expressed, including emotions after a reactive result and misuse of the kits. The lack of supervision and postcounselling is built-in to HIVST, and distress on mental health is possible.…”

Section: Discussionmentioning

confidence: 99%

‘Bringing testing closer to you’: barriers and facilitators in implementing HIV self-testing among Filipino men-having-sex-with-men and transgender women in National Capital Region (NCR), Philippines – a qualitative study

Dinglasan¹,

Rosadiño

Pagtakhan³

et al. 2022

BMJ Open

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ObjectivesOur study identified barriers and facilitators in implementing HIV self-testing (HIVST), including the perceptions of men-having-sex-with-men (MSM) and transgender women (TGW) on HIVST. Furthermore, we explored the current knowledge, practices and potential of HIVST among the MSM and TGW populations.DesignQualitative in-depth key informant interviews were administered using semistructured interviews administered in both English and Filipino. Thematic analysis of the findings was done after transcribing all audio recordings.SettingThe study was done in the National Capital Region (NCR), Philippines using online video conferencing platforms due to mobility restrictions and lockdowns caused by the COVID-19 pandemic.ParticipantsAll study participants were either MSM or TGW, 18–49 years old and residing/working in NCR. Exclusion criteria include biologically born female and/or currently on pre-exposure prophylaxis, antiretroviral therapy medications or an HIV-positive diagnosis.ResultsTwenty informants were interviewed, of which 75% were MSM, and most of them preferred the use of HIVST. Facilitators and barriers to the use of HIVST were grouped into three main themes: Acceptability, distribution and monitoring and tracking. Convenience and confidentiality, overcoming fears and normalisation of HIV testing services (HTS) in the country were the participants’ perceived facilitators of HIVST. In contrast, lack of privacy and maintenance of confidentiality during kit delivery were perceived as barriers in HIVST implementation. Moreover, social media was recognised as a powerful tool in promoting HIVST. The use of a welcoming tone and positive language should be taken into consideration due to the prevalent HIV stigma.ConclusionsThe identified facilitators and barriers from the study may be considered by the Philippine HTS programme implementers. The HIVST strategy may complement the current HTS. It will be very promising to involve the MSM and TGW communities and other key populations to know their HIV status by bringing testing closer to them.

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Coercion and HIV Self-Testing in Men Who Have Sex With Men: Implementation Data From a Cross-Sectional Survey in China

Cited by 14 publications

References 17 publications

HIV self-testing for men who have sex with men in Sweden. A cross-sectional study concerning interest to use HIV self-tests

HIV self-testing for men who have sex with men in Sweden. A cross-sectional study concerning interest to use HIV self-tests

Implementation of a campus-based and peer-delivered HIV self-testing intervention to improve the uptake of HIV testing services among university students in Zimbabwe: the SAYS initiative

‘Bringing testing closer to you’: barriers and facilitators in implementing HIV self-testing among Filipino men-having-sex-with-men and transgender women in National Capital Region (NCR), Philippines – a qualitative study

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