JMIR Publications

ABSTRACT

Background:

Late HIV diagnosis is still frequent in gay, bisexual and other men who have sex with men (GBMSM) across Europe. HIV self-sampling methodologies could help remove barriers and facilitate access to testing for this especially at-risk population.

Objective:

We assessed HIV self-sampling’s capacity to increase HIV testing frequency among GBMSM living in Denmark, Germany, Greece, Portugal, Romania and Spain and determined which subpopulations would be benefited by its introduction. We also evaluated the role of new technologies in the result communication phase.

Methods:

We analyzed 5,019 GBMSM with prior HIV testing experience recruited during 2016 through gay dating websites. We estimated the proportion of GBMSM who reported that the availability of self-sampling would result in an increase of their current testing frequency. We built one Poisson regression model per country to calculate prevalence ratios and 95% confidence intervals of factors associated to an increase of testing frequency as a result of self-sampling availability.

Results:

Some 59% (between country range: min 54.2%−max 77.2%) considered that they would test more frequently for HIV if self-sampling was available in their country. In the multivariate analysis, the increase of testing frequency as a result of self-sampling availability was independently associated with reporting higher number of unprotected anal intercourses (UAI) in all countries except Greece. Independent associations were also observed among GBMSM who were not open about their sex life in Germany, Greece, Portugal and Spain; those with a lower number of previous HIV tests in Denmark, Greece, Portugal and Spain as well as those with >3 months since their last test in Germany, Portugal, Romania and Spain. Some 58.4% (range: 40.5%−73,6%) preferred learning their result through one-way interaction methods mainly via email (25.6% range: 16.8%-35.2%) and through a secure website (20.3% range:7.3%-23.7%). Almost two thirds (65%) would still prefer one of these methods even if the result was positive.

Conclusions:

Availability of HIV self-sampling kits as an additional testing methodology would lead to a much-needed increase of testing frequency, especially among hidden, high risk and undertested GBMSM. Online-based technologies without any personal interaction were preferred for the communication of the results, even for positive results.