JMIR Publications

ABSTRACT

Background:

Of newly diagnosed HIV positive men who have sex with men in the Netherlands, 29% have a non-Western migration background (MSM-NW). Among MSM-NW, HIV positivity rates are high (0.8-2.0%) as well as the proportion of late stage infections (39%). Factors, such as HIV and sexual orientation related stigma may form barriers for timely testing. Innovative approaches for HIV testing are needed to better reach MSM-NW. Social Network Testing (SNT) for HIV is an by evidence-supported approach where peer recruiters identify persons who could benefit from testing in their social or sexual networks (network associates). Web-supported SNT might be particularly promising to reach people who may not be reached by regular care.

Objective:

The purpose of this paper is to describe the design of our pilot PREVENT (PeeR-Empowered Voluntary Extended Network Testing). In this pilot, we will explore if SNT using HIV self-tests is feasible and acceptable among MSM-NW in the Netherlands, and if it reaches those who have never, or not recently (> 1 year ago), been tested for HIV.

Methods:

The project aims to include ±50-60 MSM(-NW) peers, who will distribute 4-5 oral HIV self-tests leading to a reach of ±200 network associates (NAs). Enrolment of peers includes five steps: a) fostering interest to become a peer by health care professionals at sexual health clinics, HIV treatment clinics or community settings, b) sending contact information to the peer-coordinator, c) registration of peers and giving program instructions by the peer-coordinator, and referral to the web-based training at Time2test.nl, e) receiving pre-coded HIV self-tests for distribution in the peers’ network. NAs who receive the self-test will login with their test package code at the Time2test-application for step-by-step test instructions. After testing, NAs receive tailored follow-up information depending on their test result.

Results:

Between January and May 2019, ten STI clinics and seven HIV treatment clinics started recruiting peers. Results of the PREVENT pilot are expected in December 2020.

Conclusions:

This is the first web-supported peer-driven SNT pilot using HIV self-tests in the Netherlands, and one of the first in Europe. Implementation is considered successful if it reaches MSM-NW who were never or not recently tested for HIV. Additionally, it may encourage conversations within the networks about risk behaviour, and (barriers to) HIV testing, potentially contributing to the UNAIDS goal of zero HIV infections.