Online self-sampling kits to screen multipartner MSM for HIV and other STIs: participant characteristics and factors associated with kit use in the first 3 months of the MemoDepistages programme, France, 2018

Abstract

ObjectivesIn 2017, to reduce the proportion of men who have sex with men (MSM) in the undiagnosed HIV population in France (38%), HIV screening is advised each 3 months and STI screening is advised each year in multipartner MSM. Despite the range of testing solutions, over 40% of MSM were not tested for HIV and over 50% for STIs in the past year. Based on international experiments that offer screening solutions via online advertising, the French National Health Agency launched a programme (MemoDepistages) to provide a free self-sampling kit (SSK) for HIV and STIs. This article analyses the sociodemographic and behavioural characteristics of MSM in terms of kit acceptance and sample return.MethodsParticipants were registered for the programme online after ordering an SSK. The study included men aged over 18 years, living in one of the four selected French regions, and willing to disclose their postal and email address; they had health insurance, acknowledged more than one male partner in the past year, indicated a seronegative or unknown HIV status and were not taking medically prescribed pre-exposure prophylaxis drugs. Samples were collected by users and posted directly to the laboratory. Characteristics associated with kit acceptance and sample return were analysed using logistic regression.ResultsOverall, 7158 eligible MSM were offered to participate in the programme, with 3428 ordering the kit (47.9%) and 1948 returning their sample, leading to a return rate of 56.8% and an overall participation rate of 27.2%. Acceptance and return rates were strongly associated with sociodemographic characteristics, mainly education level but not with behavioural characteristics. Non-college graduates had lower acceptance (44.2%) and return rates (47.7%).ConclusionThe programme rapidly recruited a large number of MSM. It removed geographical inequalities related to screening access.

Online self-sampling kits for human immunodeficiency virus and other sexually transmitted infections: Feasibility, positivity rates, and factors associated with infections in France

“…5 In our participants, these sites were infrequently tested in the 12 months preceding the MemoDepistages program. 19 Urine positivity matched the lowest positivity observed in two previous French studies for this population. 5,23 This positivity mostly concerned men who did not identify themselves as homosexual or bisexual.…”

“…For extragenital sites, infections were more frequent in men under 30 years. This population also completed the MemoDepistages screening more frequently than older men when they subscribed to it, 19 highlighting the pertinence of this screening process for them.…”

“…The program was advertised on gay social media and a dating app (Hornet). 19 Participants were recruited between April 11 and June 10, 2018 after registering for the program and ordering an SSK. Consent was requested online.…”

“…The SSK contained two capillary collection lancets (BD Microtainer ® contact-activated lancet, high blood flow), a microtube for the blood sample (BDMicrotainer ® serumseparating blood collection microtube), rectal and pharyngeal swabs (Cobas R PCR Dual Swab Sample Kits or Abbott R multi-Collect Specimen Collection Kit) and a urine swab (Copan UriSwabÔ). 19 No testing selection was allowed at the time of the subscription, and all sample devices were sent to participants. The target for blood collection was 600 μl to allow for full testing.…”

“…We found that highly educated people aged under 30 years and with a recent HIV screening experience were more willing to complete the test after subscribing. 19 The potential to identify new infections using SSK thus needs to be investigated.…”