JMIR Publications

ABSTRACT

Background:

The need for strategies to encourage user-initiated results reporting after HIV self-testing (HIVST) persists. Smartphone-based electronic readers (SER) have been shown capable of reading diagnostics results accurately in point-of-care diagnostics and could bridge current gaps between HIVST and linkage to care.

Objective:

Our study aimed to assess the willingness of men who have sex with men (MSM) in Jiangsu province to use an SER for HIVST through an online cross-sectional study.

Methods:

From February to April 2020, we conducted a convenience online survey among MSM using a pretested structured questionnaire. Survey items were adapted from previous HIVST feasibility studies and modified as required. Prior to answering reader related questions, participants watched a video showcasing a prototype SER. Statistical analysis conducted included descriptive analysis, chi-squared test and multivariable logistic regression. P-value <0.05 was deemed statistically significant.

Results:

Of 692 participants, 53.3% (369) were aged 26~40 years, 65.9% (456) had ever self-tested for HIV and 71.2% (493) were willing to use an SER for HIVST. 98.0%(483/493) of willing participants, 85.3%(459/538) of ever self-tested and never self-tested, and 40% (46/115) of unwilling participants reported SERs would increase their HIVST frequency. Engaging in unprotected anal intercourse with regular partners compared to those who consistently used condoms (AOR=3.04, 95%CI=1.19-7.74) increased odds of willingness to use an SER for HIVST. Participants who had ever considered HIVST at home with a partner right before sex compared to those who had not (AOR=2.99, 95%CI=1.13-7.90) were also more willing to use an SER for HIVST. Playing receptive roles during anal intercourse compared to playing insertive roles (AOR=0.05, 95%CI=0.02-0.14) was associated with decreased odds of being willing to use an SER for HIVST. Majority of participants (73.5%, 447) preferred to purchase readers from local CDC offices and (51.2%, 311) were willing to pay less than 4.3USD for a reader device.

Conclusions:

Majority of MSM especially those with high sexual risk behaviours were willing to use an SERs for HIVST. Many MSM were also willing to self-test more frequently for HIV with an SER. Further research is needed to ascertain the diagnostic and real-time data capturing capacity of prototype SERs during HIVST.