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

*Corresponding author for this work

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Abstract

ObjectivesThe aim of the study was to explore preparedness for the HIV self-test among men who have sexwith men (MSM) and those involved in HIV prevention and care.MethodsA mixed methods exploratory research design was employed, detailing awareness and willingnessto use the self-test and the perceived barriers and facilitators to implementation. Quantitative andqualitative data collection and analysis were completed in parallel. Descriptive and inferentialanalysis 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 gaymen, National Health Service (NHS) staff, community organizations, entrepreneurs and activists.Findings were subsequently combined and assessed for synergies.ResultsAmong MSM, self-test awareness was moderate (55%). Greater awareness was associated with increasededucational attainment [adjusted odds ratio 1.51; 95% confidence interval (CI) 1.00–2.30; P = 0.05] andprevious 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 partnersonline (unadjusted odds ratio 1.96; 95% CI 1.31–2.94; P < 0.001). Experts highlighted the overallacceptability of self-testing; it was understood as convenient, discreet, accessible, and with a low burdento services. However, some ambivalence towards self-testing was reported; it could reduce opportunitiesto engage with wider services, wider health issues and the determinants of risk.ConclusionsSelf-testing represents an opportunity to reduce barriers to HIV testing and enhance preventionand access to care. Levels of awareness are moderate but willingness to use is high. Self-testingmay amplify health inequalities.
Original languageEnglish
Pages (from-to)245–255
Number of pages11
JournalHIV Medicine
Volume18
Issue number4
Early online date5 Aug 2016
DOIs
Publication statusPublished - Apr 2017

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Keywords

  • HIV prevention
  • gay men
  • MSM
  • rapid result HIV self-test

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