scholarly journals Opinions towards Key Operational Aspects for the Implementation of HIV Self-Testing in Spain: A Comparison between Stakeholders and Potential Users

2021 ◽  
Vol 18 (4) ◽  
pp. 1428
Author(s):  
Juan Hoyos ◽  
Juan-Miguel Guerras ◽  
Tomás Maté ◽  
Cristina Agustí ◽  
Laura Fernández-López ◽  
...  
Keyword(s):  
Previous Knowledge ◽  
Governmental Organization ◽  
Public Health Professionals ◽  
Sti Testing ◽  
Testing Frequency ◽  
Self Testing ◽  
Actual Choice ◽  
Self Test ◽  
Sex With Men ◽  
Operational Aspects

We assessed previous knowledge about the existence of HIV self-testing of stakeholders in Spain, as well as their personal position towards this methodology. We also assessed their views on potential users’ (PU) opinions towards several key operational aspects surrounding self-testing, and compared them to those expressed by a sample of PU comprised of men who have sex with men. In 2017, we recruited three types of stakeholders: public health professionals and policy makers (PHPPM) (n = 33), clinical providers (n = 290) and community-based/non-governmental organization (CBO/NGO) workers (n = 55). Data on PU (n = 3537) were collected in 2016. Previous knowledge about the existence of self-testing was higher in stakeholders than in PU, but being in favor was less frequent. PUs’ willingness to pay 25–30 euros for a self-test was higher than that which stakeholders considered. According to clinical providers and PHPPM, pharmacies would be PUs’ preferred place to obtain a self-test, which was in line with PUs’ actual choice. CBO/NGO workers on the other hand thought it would be CBO/NGOs. PHPPM and clinical providers considered primary care as PUs’ preferred setting to confirm a reactive self-test and CBO/NGO chose CBO/NGOs, but PUs preferred an HIV/STI testing service or clinic. Stakeholders’ opinions significantly differed from those of PUs. This divergence needs to be brought up to stakeholders as it could vary their position towards self-testing as well as the actions taken in the implementation of a testing option with the potential of increasing testing frequency.

scholarly journals Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe

2020 ◽  
Author(s):  
Clarisse Sri-Pathmanathan ◽  
Definate Nhamo ◽  
Takudzwa Mamvuto ◽  
Gwendoline Chapwanya ◽  
Fern Terris-Prestholt ◽  
...  
Keyword(s):  
Sexual Minorities ◽  
Mixed Methods Study ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sti Testing ◽  
Self Testing ◽  
Facilitators And Barriers ◽  
Self Test ◽  
Sex With Men ◽  
Depth Interviews

ABSTRACTObjectivesSelf-testing for STIs such as HIV and syphilis may empower sexual minorities and expand uptake of STI testing. While much is known about HIV self-testing (HIVST), less is known about syphilis self-testing, particularly in low-income settings. The objective of this study is to determine context-specific facilitators and barriers for self-testing and to assess the usability of syphilis self-testing in Zimbabwe among men who have sex with men (MSM).MethodsThis mixed methods study was conducted in Harare as part of a larger syphilis self-testing trial. The study included in-depth interviews (phase one) followed by usability testing and a second interview (phase two). In-depth interviews were conducted with MSM and key informants prior to syphilis self-testing. The same MSM then used the syphilis self-test, quantitatively assessed its usability and participated in a second in-depth interview. Phase one data was analysed using a thematic approach, guided by an adapted Social Ecological Model conceptual framework. Phase two interviews were analysed using Rapid Assessment Procedure qualitative methodology, and usability was assessed using a pre-established index, adapted from existing HIVST evaluation scales.ResultsTwenty MSM and 10 key informants were recruited for phase one in-depth interviews and 16 of these MSM participated in phase two by completing a syphilis self-test kit. Facilitating factors for self-testing included the potential for increased privacy, convenience, autonomy and avoidance of social and healthcare provider stigma. Barriers included the fear to test and uncertainty about linkage to care and treatment. Data from the usability index suggested high usability (89.6% on a 0-100 scale) among the men who received the self-test.ConclusionsMSM in Zimbabwe were willing to use syphilis self-test kits and many of the barriers and facilitators were similar to those observed for HIVST. Syphilis self-testing may increase syphilis test uptake among sexual minorities in Zimbabwe and other low- and middle-income countries.Key messages-Syphilis self-testing is an empowering, innovative tool that can be used to expand uptake of STI testing among sexual minorities in Zimbabwe.-Facilitators and barriers for syphilis self-testing are similar to those observed for HIV self-testing in Zimbabwe and other low- and middle-income countries.-Participants reported high self-test usability and found that self-testing provided increased privacy, convenience and autonomy in comparison to facility-based testing.

Feasibility of Indirect Secondary Distribution of HIV Self-Test Kits via WeChat Among Men Who Have Sex with Men: A National Cross-Sectional Study in China (Preprint)

2021 ◽  
Author(s):  
Li Shangcao ◽  
Jing Zhang ◽  
Xiang Mao ◽  
Tianyi Lu ◽  
Yangyang Gao ◽  
...  
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Sexual Partners ◽  
Cross Sectional ◽  
Self Testing ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Secondary Distribution ◽  
Self Test ◽  
Sex With Men

BACKGROUND The use of HIV self-test (HST) kits is commonplace in key sexually active populations. The direct secondary distribution of HST kits (DSDHK) is effective in improving the uptake of HIV self-testing. However, there are concerns about various limitations of DSDHK, including limited geographic location, payment problems, and face-to-face interaction. OBJECTIVE We evaluated the feasibility and characteristics of the indirect secondary distribution of HST kits (ISDHK) via WeChat (distributing HST application links and follow-up HST kits to partners) among men who have sex with men (MSM). METHODS From October 2017 to September 2019, an HIV self-testing (HIVST) recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for HST kits (referred to as “index participants” [Ips]). All of the MSM participants were encouraged to distribute the HST application link to their friends and sexual partners (referred to as “Alters”) through their social networks. All Alters were further encouraged to continue to distribute the HST application link. All participants paid a deposit (USD 7), refundable upon completion of the questionnaire and uploading of the test result via an online survey system. RESULTS 2,263 MSM met the criteria and successfully applied for HST. Of these, 1,816 participants returned their HST test results, including 1,422 (88.3%) IPs and 394 (21.7%) Alters. Compared with the IPs, the Alters practiced more condomless anal intercourse (CAI), a higher proportion of them never previously had an HIV test, and they had a greater willingness to distribute HST kits to sexual partners (all p < 0.05). After controlling for age, education, and income, the Alters had a greater proportion of MSM who had never tested for HIV before (aOR = 1.29, 95% CI 1.00–1.68), were more willing to distribute the HST application link (aOR = 1.71, 95% CI 1.21–2.40), had a lower number of sexual partners (aOR = 0.71, 95% CI 0.57–0.90), and were less likely to search for sexual partners via online means (aOR = 0.78, 95% CI 0.60–1.02). In comparison, the rates of reactive HST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy (ART) were similar for IPs and Alters. CONCLUSIONS The ISDHK mode of distributing HST application links via social media is feasible among the MSM population. The ISDHK mode should be used to supplement the DSDHK mode in order to enable a greater proportion of the MSM population to know their HIV infection status.

scholarly journals Potential interactions between the pathways to diagnosis of HIV and other STIs and HIV self-testing: insights from a qualitative study of gay, bisexual and other men who have sex with men in Singapore

2020 ◽  
pp. sextrans-2020-054623
Author(s):  
Rayner Kay Jin Tan ◽  
Yin Ying Chan ◽  
Muhamad Alif Bin Ibrahim ◽  
Lai Peng Ho ◽  
Oliver Zikai Lim ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Perceived Risk ◽  
Partner Notification ◽  
Barriers And Facilitators ◽  
Perceived Severity ◽  
Sti Testing ◽  
Self Testing ◽  
Sex With Men ◽  
Stis And Hiv ◽  
The Cost

ObjectivesThis study draws on qualitative insights on the barriers and facilitators to HIV testing, as well as perceptions of HIV self-testing (HIVST), to propose a framework to understand not only the benefits but also potential knock-on implications of introducing HIVST in the context of other STI testing.MethodsWe conducted semistructured, in-depth interviews with 30 gay, bisexual and other men who have sex with men aged 18 and 39 years old in Singapore. Interview topics included barriers and facilitators to HIV and other STI testing, as well as perceptions of HIVST. Interviews were audio-recorded, transcribed, coded and analysed using thematic analysis.ResultsFor HIV testing, participants cited the perceived risk of acquiring, susceptibility to and symptoms of HIV as internal motivators, while social influence and accessibility of HIV testing services were external motivators. For STI testing, perceived symptoms and partner notification of STI were reported as internal and external motivators, respectively. Availability of bundle tests, starting a new relationship and instances of mandatory testing motivated both simultaneous HIV and other STI testing. The fear of a positive diagnosis and lack of confidentiality were cited as internal and external barriers to HIV testing, respectively, while low perceived severity of other STI and the cost of STI tests were cited as internal and external barriers to other STI testing, respectively. We identified pathways to HIV and other STI testing and discussed how the introduction of HIVST may reduce opportunities for other STI testing.ConclusionsThe findings of this study suggest that introducing HIVST might weaken linkages to other STI testing if alternative strategies of promoting other STI testing are not simultaneously implemented. We recommend that future interventions address both the risks of HIV and other STI simultaneously, and that structural interventions promoting HIV and other STI preventions be balanced accordingly.

scholarly journals Exploring Mechanisms of Action: Using a Testing Typology to Understand Intervention Performance in an HIV Self-Testing RCT in England and Wales

2020 ◽  
Vol 17 (2) ◽  
pp. 466 ◽  
Author(s):  
T. Witzel ◽  
Peter Weatherburn ◽  
Adam Bourne ◽  
Alison Rodger ◽  
Chris Bonell ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Mechanisms Of Action ◽  
Logic Model ◽  
England And Wales ◽  
Social Barriers ◽  
Testing Frequency ◽  
Self Testing ◽  
Intermediate Outcomes ◽  
Sex With Men ◽  
Evidence Of Impact

SELPHI involves two interventions: A provides one HIV self-testing (HIVST) kit; B offers 3-monthly repeat HIVST kits if participants report ongoing risk. A logic model underpinned by the Behaviour Change Wheel informed the design of the intervention. SELPHI recruited 10,135 cis-men and trans people in England and Wales, all reporting anal sex with a man. This paper explores how the interventions were experienced and the mechanisms of action leading to impact for different groups of trial participants. In-depth interviews with 37 cis-men who have sex with men (MSM) were used to inductively categorise participants based on sexual and HIV testing histories. Themes relating to intervention experiences and impacts were mapped onto SELPHI-hypothesised intermediate outcomes to consider intervention impacts. Three groups were identified: ‘inexperienced testers’ engaged with SELPHI to overcome motivational and social and physical opportunity testing barriers. For ‘pro self-testers’, testing frequency was constrained by psychological and social barriers and lack of opportunity. ‘Opportunistic adopters’ engaged in HIVST for novelty and convenience. Perceived impacts for inexperienced testers were most closely aligned with the logic model, but for opportunistic adopters there was little evidence of impact. Distinctive groups were discernible with divergent intervention experiences. Using COM-B as a model for understanding behaviour change in relation to HIVST, our results indicate how HIVST interventions could be adapted to respond to different needs based on the target population’s demographic and behavioural features.

scholarly journals HIV testing practices and the potential role of HIV self-testing among men who have sex with men in Mexico

2016 ◽  
Vol 28 (3) ◽  
pp. 242-249 ◽  
Author(s):  
Catherine E Oldenburg ◽  
Katie B Biello ◽  
Amaya G Perez-Brumer ◽  
Joshua Rosenberger ◽  
David S Novak ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hiv Testing ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Intention To Use ◽  
Self Testing ◽  
Hiv Test ◽  
Self Test ◽  
Testing Practices ◽  
Sex With Men

The objective of this study was to characterize HIV testing practices among men who have sex with men in Mexico and intention to use HIV self-testing. In 2012, members of one of the largest social/sexual networking websites for men who have sex with men in Latin America completed an anonymous online survey. This analysis was restricted to HIV-uninfected men who have sex with men residing in Mexico. Multivariable logistic regression models were fit to assess factors associated with HIV testing and intention to use a HIV self-test. Of 4537 respondents, 70.9% reported ever having a HIV test, of whom 75.5% reported testing at least yearly. The majority (94.3%) indicated that they would use a HIV home self-test if it were available. Participants identifying as bisexual less often reported ever HIV testing compared to those identifying as gay/homosexual (adjusted odds ratio = 0.52, 95% confidence interval: 0.44–0.62). Having a physical exam in the past year was associated with increased ever HIV testing (adjusted odds ratio = 4.35, 95% confidence interval: 3.73–5.07), but associated with decreased interest in HIV self-testing (adjusted odds ratio = 0.66, 95% confidence interval: 0.48–0.89). The high intention to use HIV home self-testing supports the use of this method as an acceptable alternative to clinic- or hospital-based HIV testing.

scholarly journals Syphilis Self-testing: A Nationwide Pragmatic Study Among Men Who Have Sex With Men in China

2019 ◽  
Vol 70 (10) ◽  
pp. 2178-2186 ◽  
Author(s):  
Cheng Wang ◽  
Weibin Cheng ◽  
Changchang Li ◽  
Weiming Tang ◽  
Jason J Ong ◽  
...  
Keyword(s):  
Sexual Behaviors ◽  
Online Survey ◽  
Scaling Up ◽  
Cross Sectional ◽  
Self Testing ◽  
Immunodeficiency Virus ◽  
Self Test ◽  
Male Sexual Partners ◽  
Sex With Men ◽  
First Time

AbstractBackgroundSyphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing.MethodsA cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing.ResultsSix hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test and 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.32–2.73), reporting 2–5 male sexual partners (aOR, 1.81; 95% CI, 1.04–3.16), HIV self-testing (aOR, 39.90; 95% CI, 17.00–93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95% CI, 1.86–4.72). Self-reported harms associated with syphilis self-testing were minimal.ConclusionsScaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.

HIV testing self-efficacy is associated with higher HIV testing frequency and perceived likelihood to self-test among gay and bisexual men

Sexual Health ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 170 ◽  
Author(s):  
Muhammad S. Jamil ◽  
Rebecca J. Guy ◽  
Benjamin R. Bavinton ◽  
Christopher K. Fairley ◽  
Andrew E. Grulich ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Self Efficacy ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
The Past ◽  
Testing Frequency ◽  
Self Testing ◽  
The Future ◽  
Self Test ◽  
And Bisexual

Background Regular testing of individuals at higher-risk of HIV is central to current prevention strategies. The aim of the present study was to examine the extent to which confidence in one’s perceived ability to undertake various aspects of HIV testing and self-testing (self-efficacy) affected HIV testing outcomes. We assessed factors, including self-efficacy, associated with HIV testing frequency and the likelihood to self-test among gay and bisexual men (GBM). Methods: Participants were HIV-negative GBM at an increased risk of HIV (more than five partners or condomless anal intercourse in the previous 3 months) enrolled in a randomised controlled trial of HIV self-testing. The baseline questionnaire captured data regarding sociodemographic characteristics, HIV and/or sexually transmissible infection testing history, sexual behaviour, beliefs and attitudes towards HIV and eight items capturing confidence in HIV testing ability that were combined as a single broad measure of HIV testing self-efficacy (α = 0.81). Factors associated with three or more HIV tests in the past year and the likelihood of self-testing in the future were determined using logistic regression. Results: Of 354 GBM, 34% reported three or more HIV tests in the past year, and 64% reported being ‘very likely’ to self-test. Factors independently associated with three or more HIV tests in the past year were: higher self-efficacy (adjusted odds ratio (aOR) 1.08 per unit increase; 95% confidence interval (CI) 1.02–1.14; P = 0.004); >10 male partners in the past 6 months (aOR 1.79; 95% CI 1.05–3.04; P = 0.031) and higher optimism regarding the effects of HIV treatments on HIV transmission (aOR 1.14; 95% CI 1.00–1.29; P = 0.044). Only higher self-efficacy was independently associated with reporting a greater likelihood to self-test in the future (aOR 1.10; 95% CI 1.05–1.15; P < 0.001). Conclusions: Improving self-efficacy by enhancing GBM’s knowledge and experience may lead to higher testing frequency. The self-efficacy measure used in the present study could be useful in identifying GBM likely to face difficulties with HIV testing and self-testing.

scholarly journals Operationalizing the distribution of oral HIV self-testing kits to men who have sex with men (MSM) in a highly homophobic environment: the Nigerian experience

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Adekemi Sekoni ◽  
Waimar Tun ◽  
Osasuyi Dirisu ◽  
Temitope Ladi-Akinyemi ◽  
Elizabeth Shoyemi ◽  
...  
Keyword(s):  
Group Discussions ◽  
The Sustainable Development ◽  
Effective Strategies ◽  
Qualitative Survey ◽  
Self Testing ◽  
Test Kit ◽  
Community Skills ◽  
Development Goals ◽  
Self Test ◽  
Sex With Men

Abstract Background Self-care health interventions are innovative approaches for improving health and achieving the sustainable development goals (SDGs). Men who have sex with men (MSM) have been disproportionately affected by Human Immunodeficiency Virus (HIV). In spite of this, stigma from healthcare workers has reportedly prevented MSM from accessing HIV testing in health facilities. This paper explored the operationalization of using key opinion leaders (KOLs) to distribute HIVST (HIV self-test) kits to MSM. This qualitative survey used a combination of in-depth interviews (IDI) with HIVST users and focus group discussions (FGDs) with KOLs to collect data three months after the distribution of the test kits by the KOLs. Thematic analysis of the data was carried out. Result Three themes were generated namely: KOLs serve as a trusted resource to promote and support HIVST for the MSM community; Skills and qualifications required for KOLs to effectively distribute and promote uptake of HIVST; and Effective strategies used to create demand and promote uptake of HIVST. Conclusion This study showed the practical steps involved in operationalizing KOL support system distribution of HIVST that positively influenced the testing experience for the participants irrespective of the HIV status and engagement in care. KOLs are a reliable resource to leverage for ensuring that HIV self-test kit is utilized and HIV positive individuals are linked to treatment and care in homophobic environments.

scholarly journals Evaluation and enumeration of online test providers for sexually transmitted infections, specifically chlamydia, in the Netherlands

2019 ◽  
Vol 95 (5) ◽  
pp. 380-385 ◽  
Author(s):  
Chantal den Daas ◽  
Bob Sukel ◽  
Hanna Bos ◽  
Ingrid van den Broek
Keyword(s):  
The Netherlands ◽  
Quality Indicators ◽  
Online Testing ◽  
Sexually Transmitted ◽  
Online Test ◽  
Sti Testing ◽  
Self Testing ◽  
Regular Care ◽  
Sample Test ◽  
Self Test

ObjectivesOnline testing for STIs might complement regular care provided by general practitioners or STI clinics. Two types of online testing can be distinguished, self-testing and self-sampling (sending sample to a laboratory for diagnosis). Online testing can occur without consultation with a healthcare professional, therefore information given by providers is essential for informed decision-making. We aimed to enumerate online test providers in the Netherlands focusing on chlamydia tests, to evaluate information using quality indicators and to gain insight on the proportion of online testing in the STI testing arena.MethodsWe performed a systematic internet search to identify online STI test providers. Twenty quality indicators were evaluated on their websites; indicator scores were weighted by level of importance (expert opinion). High scoring providers were recommended, on the condition that the sensitivity and specificity of the test were above 95% and providers included a follow-up procedure in case of a positive result. Finally, providers were contacted to inquire about the number of sold tests, positivity rates and demographic characteristics of testers.ResultsFive out of 12 identified self-sample test providers could be recommended, versus zero out of eight self-test providers. Self-sample test providers gave complete and correct information on more indicators (67%) compared with self-test providers (38%). In 2015, an estimated 30 000–40 000 self-sample tests were purchased, and 12 000–25 000 self-tests, which is roughly 10%–15% of the total number of STI tests.ConclusionThis evaluation shows that some online self-sample test providers could be put forward as way of STI testing complementing regular testing options. None of the self-test providers were recommended. Regularly evaluating online test providers is advised to improve quality of the information on the websites. Finally, self-testing might not be suited for all populations as most information is provided in written format only.

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