JMIR Publications

ABSTRACT

Background:

Hispanic/Latinx gay, bisexual, and other sexual minority men (SMM) are disproportionately affected by HIV in the United States. With the availability of HIV/STI self-testing services, through which individuals can self-collect specimens to screen for HIV and other STIs, HIV/STI testing may be more accessible for Latinx SMM who are foreign born and face multiple obstacles to obtaining HIV prevention services. Combining the potential of self-testing kits and the influence of peer educators may present an opportunity to address barriers and increase HIV/STI testing and PrEP uptake among Latinx immigrant SMM.

Objective:

The study’s objective was to develop and pilot a peer intervention to distribute HIV/STI self-testing kits and to provide peer counseling based on the Information-Motivation-Behavioral Skills (IMB) model to relay information, enhance motivation, and reinforce behavioral skills to increase PrEP uptake and HIV/STI testing behaviors among Latinx immigrant SMM.

Methods:

We conducted semi-structured interviews with community stakeholders (N=15) to elicit important factors to consider for training and intervention implementation with Latinx immigrant SMM. Interview findings informed the development of the intervention and peer training protocols. We randomly assigned participants to the intervention group, who received peer-counseling and HIV/STI self-testing kits, or to the control group, who only received peer counseling. We administered baseline, 1-week, 6-week, and 12-week follow-up surveys to assess self-reports of motivation and behaviors related to PrEP uptake, HIV testing, and STI testing. Due to the COVID-19 pandemic, all intervention components were delivered virtually (e.g., phone, internet). We performed 2-sample tests for equality of proportions with continuity correction to examine the effects of the intervention on self-reports of PrEP uptake, HIV testing, and STI testing motivation and behaviors.

Results:

A total of 50 Latinx immigrant SMM participated: 30 in the intervention group and 20 in the control group. Eighty percent of participants across both groups indicated that the peer-based program motivated them to get tested for HIV. Post intervention, there were no differences between groups in reports of HIV testing. At 12 weeks post-intervention, 73% of SMM in the intervention group and 37% in the control group reported having tested for STIs (P=.02). Among participants in the intervention group, 84% reported being motivated to use PrEP compared to 59% in the control group (P=.07).

Conclusions:

By facilitating access to HIV/STI testing through self-testing kits and enhancing testing and PrEP information, motivation, and behavioral skills through peers, our intervention demonstrated potential to increase HIV prevention behaviors in Latinx immigrant SMM. Peer-based programs that offer self-testing and virtual modes of accessing information may be a feasible and acceptable strategy to reach Latinx immigrant SMM. Clinical Trial: NCT03922126