Integrated HIV self-testing (HIVST) service delivery in Queensland for policy and service development: study protocol

Abstract

This study aims to pilot and evaluate an integrated model for HIV self-testing (HIVST) service delivery in a peer-led Queensland community setting to increase access to HIVST, particularly for men who have sex with men (MSM) living in regional, remote and rural areas. It seeks to provide evidence that would overcome some of the key objections previously raised to HIVST. Recruitment strategies have been designed to engage hard to reach MSM populations in testing. Awareness of the trial will be generated through advertising on social media platforms, including dating applications, word of mouth and HIV related websites. Participants will access an HIVST online ordering system hosted by a HIV community organisation. This system: (1) enables on-line informed consent; 2) gives clients the choice to accept verbal pre-test information from a trained peer test facilitator or not; and (3) allows for ordering of the HIVST kit after completion of an online survey (with demographic information and testing history etc.). Clients receive the kits via the post; and at 2 weeks receive a follow-up phone-call and SMS link to a post-test survey. If the test is non-reactive, clients can opt for test reminders. If reactive, referral to clinical services, peer navigation and support systems are provided. This study addresses important gaps in understanding of acceptable and feasible methods to integrate HIVST into an existing peer-led testing service and into the broader suite of HIV testing options and services. The findings will inform the actions needed to enhance access to HIVST for MSM wishing to use this technology in Australia and elsewhere, especially those who have never tested and infrequent testers.

Impact of a personalised, digital, HIV self-testing app-based program on linkages and new infections in the township populations of South Africa

“…Globally, linkage data for digital unsupervised HIVST with app-based programs are sparse. Linkage data for HIVST (without a digital component) varies between 51% and 81% 1 and has been reported from many countries: Thailand, 26 China, 27 28 Vietnam, 29 Singapore, 30 the Americas (Brazil, 31 USA 32–34 and Canada), 23 24 Australia 35 and Europe (Spain). 36 We believe that our customised, unincentivised, 24/7 digital program offered by our healthcare workers, together with a choice of strategy and venue to test, contributed to the success of our strategy.…”

Sustaining success: a qualitative study of gay and bisexual men’s experiences and perceptions of HIV self-testing in a randomized controlled trial

“…Indeed, clinics and health agencies seeking to deploy HIVST should consider more advocacy strategies, for example if creating multiple channels for delivery of tests would help more fully realise the potential benefits of self-testing for HIV. A few studies have provided evidence that using mobile technology [ 22 , 23 ] or peer telephone contact [ 24 ] in concert with mailed HIVST kits are feasible and useful strategies for promoting HIVST and linkage to HIV-related care among GBM. Our findings also strengthen the argument that the less expensive access to HIVST is for the end user, the more likely it is to be taken up as an ongoing routine [ 25 ].…”

Online HIV Self-Testing (HIVST) Dissemination by an Australian Community Peer HIV Organisation: A Scalable Way to Increase Access to Testing, Particularly for Suboptimal Testers

“…UQ coordinated and conducted the M&E component and analysed de-identified data. The study protocol has been previously described in detail [ 38 ]. This paper presents the results of the quantitative online survey data collected pre- and post-dissemination of the kits.…”

“…Requesting delivery of the HIVST kit to a postcode outside of Queensland was the primary exclusion criterion. A combination of five active recruitment strategies described in more depth previously [ 38 ] were employed, including: Geotargeted advertising via mobile online banner advertisements on two gay-identifying apps (i.e., Grindr and Squirt) and Facebook; Promotion on non-gay-identifying classified advertisement websites (e.g., Craigslist); Dissemination of study information in gay press and by HIV and peer organisation websites in Queensland; Search engine optimization (SEO); Word of mouth and respondent-driven sampling. …”

“…Access to these data may be considered by contacting the corresponding author of this manuscript. Access to the full study protocol is available in print [ 38 ].…”