HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review.

Varsicka Kularadhan,Joscelyn Gan,Jason J. Ong,Eric P. F. Chow,Christopher K. Fairley

doi:10.3390/ijerph19053002

Abstract

Background: Regular testing for HIV and other sexually transmitted infections (STI) is recommended at least annually for sexually active men who have sex with men (MSM) in most high-income countries. To encourage regular use of HIV and STI testing and treatment services for MSM, we reviewed the literature to summarise the attributes of an HIV/STI testing service that MSM prefer. Method: We conducted a scoping review, searching PubMed, EMBASE, PsycINFO and CINAHL in January 2020 for articles reporting primary data on the preferences of MSM (living in high-income countries) for HIV/STI testing services. Two reviewers independently screened titles and abstracts and any discrepancies were resolved by a third reviewer. We extracted data on the service attributes that MSM preferred and summarised these thematically using a socioecological framework. Results: In total, 1464 publications were identified, 220 full texts were read and 57 were included in the final analysis. We found 21 articles addressing ‘individual’ attributes, 50 articles addressing ‘service’ attributes and 17 articles addressing ‘societal’ attributes. The key themes of preferences for HIV/STI testing services were: (1) the appeal of self-testing due to convenience and privacy; (2) the need to provide a variety of testing options; and (3) the influence of the testing experience, including confidentiality and privacy, tester characteristics and stigma. There were distinct patterns of preferences for subpopulations of MSM across studies, such as the preference of self-testing for young MSM, and of in-clinic testing for those who perceived themselves as high risk (i.e., with symptoms of STIs or exposed to a partner living with HIV). Conclusion: To make HIV/STI testing more accessible for MSM and encourage regular screening, it is important to address ‘individual’, ‘service’ and ‘societal’ attributes, such as enhancing the convenience of testing through self-testing, and providing a service that men feel comfortable and safe accessing. Furthermore, services should accommodate the preferences of diverse sub-populations within the MSM community.

Highlights

Worldwide, there was estimated to be 1.7 million new HIV infections in 2019, and this has declined significantly over the last ten years, numerous countries are not on track to meet 2020 and 2030 global targets for reductions in HIV incidence and mortality [1,2]
We aimed to answer the following review question “In men who have sex with men (MSM) living in high-income countries, which attributes of HIV/sexually transmitted infections (STI) testing services do they prefer and not prefer?” To allow comparability between articles, we did not include publications from low- and middleincome countries as there are significant differences in their health systems compared to high-income countries
A study conducted in the UK that focused on home-sampling kits highlighted that MSM found a ‘no news is good news’ approach caused anxiety and uncertainty, and participants preferred to be notified with a negative result [15]

Summary

Introduction

There was estimated to be 1.7 million new HIV infections in 2019, and this has declined significantly over the last ten years, numerous countries are not on track to meet 2020 and 2030 global targets for reductions in HIV incidence and mortality [1,2]. Regular testing for HIV and other sexually transmitted infections (STI) is recommended at least annually for sexually active men who have sex with men (MSM) in most high-income countries. To encourage regular use of HIV and STI testing and treatment services for MSM, we reviewed the literature to summarise the attributes of an HIV/STI testing service that. Method: We conducted a scoping review, searching PubMed, EMBASE, PsycINFO and CINAHL in January 2020 for articles reporting primary data on the preferences of MSM (living in high-income countries) for HIV/STI testing services. We extracted data on the service attributes that MSM preferred and summarised these thematically using a socioecological framework

Objectives

Methods

Results

Discussion

Conclusion