Clinical and community views of the instant result HIV self-testing: barriers and facilitators for effective implementation amongst MSM (men who have sex with men).

Jamie Frankis, Caroline Park, Bipasha Ahmed, Karen Lorimer, Mark Davis, Paul Flowers

Research output: Contribution to conferencePoster

Abstract

Objectives: Instant-result HIV self-test kits became legal in the UK and most other European countries in early 2014, with the first commercial products available soon after. Here, we report anticipatory perspectives from a range of key stakeholders concerning the barriers and facilitators to the effective use of instant-result HIV self-test kit in the UK.
Methods: Twelve focus groups (n=55) were conducted with MSM (urban and rural residents), entrepreneurs (gay shop owners, sex-sauna staff), gay activists, NHS staff (urban and rural practices) and community organisations (gay-specific and wider health agencies). Data were analysed thematically using NVivo.
Results: Key facilitators enabling the effective implementation of self-testing were the tests’ perceived convenience, the speed of testing/results, high levels of discretion and privacy, avoiding the perceived stigma of using GUM services, the potential of the test to reach new populations and to rationalise clinical time and resources. Key barriers were perceptions of the high levels of health literacy, skills and competencies required to use the test properly, perceptions of packaging/branding as potentially problematic, perceptions of poor trust and low perceived accuracy, lost opportunities for engagement with additional services and professional staffs, a sense of deracinating HIV from wider holistic health, and concerns regarding the perceived negative consequences of receiving ‘positive’ results (suicide, distress, isolation, loss from care) outwith a care setting.
Conclusion: Stakeholders expressed ambivalence around self-testing, though it was also seen as convenient, accessible and low-burden to the NHS. However, self-testing reduces opportunities to engage with wider services and decouples HIV from wider health and the determinants of risk, whilst raising issues of health literacy and the amplification of health inequalities. The self-test will enable new populations to test, in new ways, transforming the relative heterogeneity of the testing experience. As commercial products become available it is vital the sector prepares for their impact.
Original languageEnglish
PagesPE23/19
Publication statusPublished - 21 Oct 2015

Keywords

  • HIV
  • self assesment
  • MSM

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