HIV self-test: a tool to expand test uptake among men who have sex with men who have never been tested for HIV in São Paulo, Brazil

Ricardo Vasconcelos; Vivian I Avelino-Silva; Ivone A de Paula; Leda F Jamal; Maria Clara Gianna; Flavio Santos; Robinson Camargo; Eduardo Barbosa; Gilvane Casimiro; Vanda Cota; Maria C Abbate; Marly Cruz; Aluisio C Segurado

doi:10.1111/hiv.13178

HIV self-test: a tool to expand test uptake among men who have sex with men who have never been tested for HIV in São Paulo, Brazil

HIV Med. 2022 May;23(5):451-456. doi: 10.1111/hiv.13178. Epub 2021 Oct 11.

Affiliations

¹ Department/Division of Infectious Diseases, Faculty of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
² STD/AIDS Reference and Training Centre, State Secretariat of Health of São Paulo, São Paulo, Brazil.
³ STI/AIDS Coordination of the city of São Paulo, Municipal Secretariat of Health, São Paulo, Brazil.
⁴ Diversity Reference and Defense Centre, São Paulo, Brazil.
⁵ Department of Chronic Health Conditions and Sexually Transmitted Infections, Ministry of Health, Brasilia, Brazil.
⁶ National School of Public Health, Fiocruz, Rio de Janeiro, Brazil.

PMID: 34634182
DOI: 10.1111/hiv.13178

Abstract

Objectives: HIV self-testing is an effective tool to improve diagnostic coverage in key populations, enabling linkage to care and access to antiretroviral therapy. Its implementation requires better understanding of patients' perspectives on this novel strategy. The aim of the study was to investigate the perception of men who have sex with men (MSM) regarding the HIV oral fluid self-test (HIVST) in São Paulo, Brazil, and to analyse the sociodemographic characteristics and testing strategy preferences of individuals registered to undertake HIVST.

Methods: Preceding the implementation of HIVST use as public policy in 2019, we recruited MSM living in São Paulo to undertake HIVST using a digital platform, and investigated their sociodemographic profiles, testing experiences and testing preferences. Results were compared according to reported lifetime HIV testing.

Results: A total of 6477 MSM (median age 28 years) were recruited to the study from April 9th to December 31st, 2018. Seventy-eight per cent reported previous HIV testing. The opening hours of health facilities (53%), concern about disclosing intimate personal information to health care providers (34%) and fear of stigma (21%) were reported as the main barriers to testing. Older age, higher education, illicit drug use and self-identifying as gay were associated with prior HIV testing (P < 0.001). Most participants (67%) were unaware that HIVST was available before enrolling in the study. Preference for HIVST over other testing technologies was higher among those never tested (71%) than among participants with previous HIV testing (61%; P < 0.001).

Conclusions: HIVST was found to be an effective tool to improve testing uptake among MSM, particularly those who had never been tested before. Characterization of the most likely users of HIVST among MSM will help to inform implementation and scaling up of this novel testing method in the Brazilian public health system.

Keywords: Brazil; HIV; early diagnosis; homosexuality; public health; self-testing.

Publication types

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

MeSH terms

Adult
Brazil
HIV Infections* / diagnosis
Homosexuality, Male
Humans
Male
Self-Testing
Sexual and Gender Minorities*