Preparedness for use of the rapid result HIV self-test by gay men and other men who have sex with men (MSM): a mixed methods exploratory study among MSM and those involved in HIV prevention and care

P Flowers; J Riddell; C Park; B Ahmed; I Young; J Frankis; M Davis; M Gilbert; C Estcourt; L Wallace; L M McDaid

doi:10.1111/hiv.12420

Preparedness for use of the rapid result HIV self-test by gay men and other men who have sex with men (MSM): a mixed methods exploratory study among MSM and those involved in HIV prevention and care

HIV Med. 2017 Apr;18(4):245-255. doi: 10.1111/hiv.12420. Epub 2016 Aug 5.

Authors

P Flowers¹, J Riddell², C Park^{1

2}, B Ahmed¹, I Young², J Frankis¹, M Davis³, M Gilbert⁴, C Estcourt⁵, L Wallace⁶, L M McDaid²

Affiliations

¹ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
² MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
³ School of Social Sciences, Monash University, Melbourne, Vic., Australia.
⁴ Applied Epidemiology Unit, Ontario HIV Treatment Network, Toronto, ON, Canada.
⁵ Barts and the London School of Medicine and Dentistry, Barts Sexual Health Centre, Blizard Institute, London, UK.
⁶ Health Protection Scotland, Glasgow, UK.

Abstract

Objectives: The aim of the study was to explore preparedness for the HIV self-test among men who have sex with men (MSM) and those involved in HIV prevention and care.

Methods: A mixed methods exploratory research design was employed, detailing awareness and willingness to use the self-test and the perceived barriers and facilitators to implementation. Quantitative and qualitative data collection and analysis were completed in parallel. Descriptive and inferential analysis of cross-sectional bar-based survey data collected from MSM through a self-completed questionnaire and oral fluid specimen collection (n = 999) was combined with qualitative, thematic, analysis of data collected through 12 expert focus groups (n = 55) consisting of gay men, National Health Service (NHS) staff, community organizations, entrepreneurs and activists. Findings were subsequently combined and assessed for synergies.

Results: Among MSM, self-test awareness was moderate (55%). Greater awareness was associated with increased educational attainment [adjusted odds ratio 1.51; 95% confidence interval (CI) 1.00-2.30; P = 0.05] and previous history of sexually transmitted infection (STI) testing (adjusted odds ratio 1.63; 95% CI 1.11-2.39; P = 0.01). Willingness to use the test was high (89%) and associated with meeting sexual partners online (unadjusted odds ratio 1.96; 95% CI 1.31-2.94; P < 0.001). Experts highlighted the overall acceptability of self-testing; it was understood as convenient, discreet, accessible, and with a low burden to services. However, some ambivalence towards self-testing was reported; it could reduce opportunities to engage with wider services, wider health issues and the determinants of risk.

Conclusions: Self-testing represents an opportunity to reduce barriers to HIV testing and enhance prevention and access to care. Levels of awareness are moderate but willingness to use is high. Self-testing may amplify health inequalities.

Keywords: HIV prevention; HIV testing; men who have sex with men; sexual health; sexual risk behaviour.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Diagnostic Tests, Routine / methods*
HIV Infections / diagnosis*
Health Knowledge, Attitudes, Practice*
Homosexuality, Male
Humans
Male
Middle Aged
Self-Examination / methods*
Sexual and Gender Minorities*
Surveys and Questionnaires
Time Factors
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding