Abstract
HIV self-testing (HIVST) introduces opportunities for screening in non-conventional settings, and addresses known testing barriers. This study involved the development and evaluation of a free online HIVST dissemination service hosted by a peer-led, community-based organisation with on-site, peer-facilitated HIV testing, and established referral and support programs for people newly diagnosed with HIV to determine whether this model was feasible and acceptable for engaging MSM, particularly among infrequent and naive HIV-testers, or those living in remote and rural areas. Between December 2016 and April 2018, 927 kits were ordered by 794 individuals, the majority of whom were men who have sex with men (MSM) (62%; 494), having condomless sex (50%; 392), or living outside a major city (38%; 305). Very few (5%; 39) sought the available pre-test peer contact, despite 45% (353) being naive HIV-testers. This study demonstrates that online HIVST dissemination is acceptable and feasible for engaging at-risk suboptimal testers, including those unwilling to test elsewhere (19%; 47/225). With half (50%; 403) unwilling to buy a kit, our study suggests that HIVST will need to be subsidized (cost-neutral to users) to enhance population coverage and access.
Highlights
IntroductionTesting and diagnosis facilitate timely access to HIV treatment and ongoing care, resulting in improved health outcomes and prevention of onward transmission
Introduction iationsAccess to HIV treatment is a vital element for the control and elimination of HIV [1].Early testing and diagnosis facilitate timely access to HIV treatment and ongoing care, resulting in improved health outcomes and prevention of onward transmission
The study involved the development of a study registration page hosted on the established Queensland Positive People (QPP) website, which linked to an online order system for the HIV self-testing (HIVST) kit
Summary
Testing and diagnosis facilitate timely access to HIV treatment and ongoing care, resulting in improved health outcomes and prevention of onward transmission. Improving access to and uptake of HIV testing is a critical strategy for reducing the number of people living with undiagnosed HIV [2]. More recent national data from 2018 estimate that the proportion of Australian MSM living with undiagnosed HIV has fallen to 9% [5]. This suggests that Australia is moving in the right direction, towards achieving 95% of people living with HIV (PLHIV) being aware of their diagnosis [3].
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