Pressure to Use HIV Self-Tests Among Men Who Have Sex With Men, United States, 2015–2016

Gwynn, Melanie; Chavez, Pollyanna R; Borkowf, Craig B.; Raiford, Jerris L.; Gravens, Laura; MacGowan, Robin J.

doi:10.1007/s10461-021-03422-6

Cited by 3 publications

(2 citation statements)

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“…5 However, it is not clear if harms data were routinely reported; one included RCT has since reported 8.5% of MSM (n=60/709) reported pressuring someone else to test, and 2.1% (n=15/715) being pressured themselves. 17 Some evidence from observational studies exists in high-income settings, mostly confrontations with sexual partners when delivering HIVST. 18 19 As the biggest HIVST RCT in a high-income setting and the largest including MSM to date, SELPHI provides a unique opportunity to investigate and characterise harms to guide HIVST implementation.…”

Section: Original Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding experiences of potential harm among MSM (cis and trans) using HIV self-testing in the SELPHI randomised controlled trial in England and Wales: a mixed-methods study

Witzel,

Nicholls,

McCabe

et al. 2023

Sex Transm Infect

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BackgroundThe potential of HIV self-testing (HIVST) to cause harm is a concern hindering widespread implementation. The aim of this paper is to understand the relationship between HIVST and harm in SELPHI (An HIVSelf-testingPublicHealthIntervention), the largest randomised trial of HIVST in a high-income country to date.Methods10 111 cis and trans men who have sex with men (MSM) recruited online (geolocation social/sexual networking apps, social media), aged 16+, reporting previous anal intercourse and resident in England or Wales were first randomised 60/40 to baseline HIVST (baseline testing, BT) or not (no baseline testing, nBT) (randomisation A). BT participants reporting negative baseline test, sexual risk at 3 months and interest in further HIVST were randomised to three-monthly HIVST (repeat testing, RT) or not (no repeat testing, nRT) (randomisation B). All received an exit survey collecting data on harms (to relationships, well-being, false results or being pressured/persuaded to test). Nine participants reporting harm were interviewed in-depth about their experiences in an exploratory substudy; qualitative data were analysed narratively.ResultsBaseline: predominantly cis MSM, 90% white, 88% gay, 47% university educated and 7% current/former pre-exposure prophylaxis (PrEP) users. Final survey response rate was: nBT=26% (1056/4062), BT=45% (1674/3741), nRT=41% (471/1147), RT=50% (581/1161).Harms were rare and reported by 4% (n=138/3691) in exit surveys, with an additional two false positive results captured in other study surveys. 1% reported harm to relationships and to well-being in BT, nRT and RT combined. In all arms combined, being pressured or persuaded to test was reported by 1% (n=54/3678) and false positive results in 0.7% (n=34/4665).Qualitative analysis revealed harms arose from the kit itself (technological harms), the intervention (intervention harms) or from the social context of the participant (socially emergent harms). Intervention and socially emergent harms did not reduce HIVST acceptability, whereas technological harms did.DiscussionHIVST harms were rare but strategies to link individuals experiencing harms with psychosocial support should be considered for HIVST scale-up.Trial registration numberISRCTN20312003.

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Section: Original Researchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding experiences of potential harm among MSM (cis and trans) using HIV self-testing in the SELPHI randomised controlled trial in England and Wales: a mixed-methods study

Witzel,

Nicholls,

McCabe

et al. 2023

Sex Transm Infect

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Accelerating Human Immunodeficiency Virus Self-Testing in the United States: A Call to Action

MacGowan

Mermin

et al. 2023

Clinical Infectious Diseases

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HIV self-testing has emerged as a tool to increase the proportion of people to know their status. Since the first HIV self-test was approved in 2012 by the FDA, global access to HIV self-tests has been bolstered by public-private partnerships to ensure equitable access in low- and middle-income countries (LMICs). However, no company has applied for FDA clearance in a decade. We highlight the potential benefits to reclassifying HIV self-tests from class III to class II.

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Coerced syphilis self-testing among men who have sex with men: a nationwide cross-sectional study in China

2022

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Background Syphilis testing uptake remains low among men who have sex with men (MSM) in many low-and middle-income countries. Syphilis self-testing is an efficacious approach on increasing syphilis testing coverage. However, one unintended consequence is the syphilis self-testing coercion from others (including partners, healthcare providers, friends, etc.). This study aimed to examine the prevalence, pattern and correlates of coerced syphilis self-testing among MSM in China. Methods A nationwide online cross-sectional study was conducted from 14 to 28 July 2018. Sociodemographic characteristics, sexual behaviors and coerced syphilis self-testing variables were collected through a questionnaire that targeted MSM in China. Multivariable logistic regression was used to explore associated factors with syphilis self-testing coercion. Results Overall, 174 MSM were recruited in this study, 31 men (17.8%) reported ever experiencing syphilis self-testing coercion. The most common types of coercion before syphilis self-testing were verbal abuse (38.7%, 12/31) and threatening to end a relationship (38.7%, 12/31). After obtaining the self-test results, men were mostly subjected to end a relationship (45.2%, 14/31) and threaten of violence (35.5%, 11/31). Multivariable logistic regression indicated that men who used condoms inconsistently in the past three months, ever used substances before or during sex, ever had group sex with males and commercial sex were more likely to experience syphilis self-testing coercion. Conclusions Coerced syphilis self-testing was prevalent among MSM in China. Innovative intervention to reduce coerced syphilis self-testing is necessary among MSM in China.

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Pressure to Use HIV Self-Tests Among Men Who Have Sex With Men, United States, 2015–2016

Cited by 3 publications

References 13 publications

Understanding experiences of potential harm among MSM (cis and trans) using HIV self-testing in the SELPHI randomised controlled trial in England and Wales: a mixed-methods study

Understanding experiences of potential harm among MSM (cis and trans) using HIV self-testing in the SELPHI randomised controlled trial in England and Wales: a mixed-methods study

Accelerating Human Immunodeficiency Virus Self-Testing in the United States: A Call to Action

Coerced syphilis self-testing among men who have sex with men: a nationwide cross-sectional study in China

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