scholarly journals Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S426-S426
Author(s):  
Nitika Pant Pai ◽  
Megan Smallwood ◽  
Laurence Desjardins ◽  
Alexandre Goyette ◽  
Anne-Fanny Vassal ◽  
...  
Keyword(s):  
Testing Procedure ◽  
The Self ◽  
Health Clinic ◽  
Test Results ◽  
Testing Strategy ◽  
Self Testing ◽  
Hiv Test ◽  
Post Test ◽  
Self Test ◽  
Sex With Men

Abstract Background Although HIV self-tests are recommended by the WHO, they are not yet approved in Canada. Service delivery gaps such as linkages to counseling and care remain unachieved by offering self-tests without adequate support. In this first Canadian study, we evaluated the feasibility of operationalizing an innovative HIVSmart! app-optimized oral HIV self-testing strategy in men who have sex with men (MSM), presenting at a large sexual health clinic in Montreal. Methods Between July 2016 to February 2017, participants were offered the OraQuick In-Home HIV Test, and a tablet installed with the HIVSmart! app, at a private office in the clinic to simulate an unsupervised home environment. With the HIVSmart! app, participants independently performed and interpreted self-tests, and were linked to in-person post-test counseling and care. Self-test results were confirmed by laboratory tests (p24, Western Blot, RNA as needed). Results The mean age of the 451 participants was 34 years (18–73); 85% were well educated (beyond high school, n = 371/438); 53% (230/438) were frequent testers (past 6 months), and 13% were on PrEP (52/451). 99% (417/422) of participants found the HIVSmart! app helpful in guiding them through the self-testing procedure; 93% (418/451) of participants interpreted their tests accurately; and 94% (395/419) stated they would recommend the app-optimized self-testing strategy to their partners. Feasibility (completion rate of self-testing) was 93% (419/451), and acceptability of the strategy was high at 99% (451/458). All HIV self-test negative participants (448/451, 100%) were counseled following the self-test. Three participants self-tested positive, were confirmed HIV positive (0.7% prevalence), and were rapidly linked to care with a physician. Conclusion The HIVSmart! app-optimized strategy was feasible, and highly accepted by an educated, frequently testing, urban MSM population of Montréal. With the app, participants were able to interpret their test results accurately and were rapidly linked to care. Innovations like HIVSmart! which engage, aid, and facilitate linkages to care, can be adapted to suit the needs of many populations in Canada and internationally, maximizing global impact through reverse innovation. Disclosures All authors: No reported disclosures.

scholarly journals An Unsupervised Smart App–Optimized HIV Self-Testing Program in Montreal, Canada: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Nitika Pant Pai ◽  
Megan Smallwood ◽  
Laurence Desjardins ◽  
Alexandre Goyette ◽  
Krisztian G Birkas ◽  
...  
Keyword(s):  
Rapid Test ◽  
Health Impact ◽  
Completion Rate ◽  
World Health ◽  
Health Clinic ◽  
Testing Strategy ◽  
Cross Sectional ◽  
Self Testing ◽  
Hiv Test ◽  
Self Test

BACKGROUND Although HIV self-testing strategies have been recommended by the World Health Organization, HIV self-tests are not yet approved in Canada. Currently approved HIV self-tests offer toll-free lines that are insufficient for initiating expedited linkages to counseling and care, accurate interpretation, and support during HIV self-testing. We developed an innovative, multilingual software app called HIVSmart! to plug these gaps. OBJECTIVE This study aimed to test our app-optimized oral HIV self-testing strategy for feasibility in men who have sex with men (MSM) who presented to test at a large sexual health clinic (Clinique Médicale L’Actuel) in Montreal. METHODS Between July 2016 and February 2017, we offered a strategy consisting of the OraQuick In-Home HIV Test (an investigational device) and a tablet installed with the HIVSmart! app to study participants, who presented at a private office in the clinic, mimicking an unsupervised home environment. We evaluated the strategy for its feasibility, acceptability, and preference. Using the HIVSmart! app, participants were guided through the self-testing process. We determined feasibility with a metric defined as the completion rate, which consisted of the following 3 steps: (1) self-test conduct; (2) self-test interpretation; and (3) linkages to care. Participants independently performed, interpreted, recorded their self-test and result, engaged in pre- and posttest counseling, and sought linkages to care. Laboratory tests (p24, Western Blot, and RNA), as per country algorithms, were expedited, and linkages based on the rapid test status were arranged. RESULTS Mean age of the 451 participants enrolled was 34 (range, 18-73) years. Of all participants, 97.1% (438/451) completed and submitted the survey through the HIVSmart! app. In total, 84.7% (371/438) of the participants were well educated (beyond high school) and 52.5% (230/438) had been tested within the past 6 months. Of the 451, 11.5% (52/451) were on pre-exposure prophylaxis. Feasibility (completion rate), an average proportion of the 3 steps, was computed to be 96.6% (419/451). The acceptability of the strategy was high at 98.5% (451/458). A majority of the participants (448/451, 99.3%) were found to be self-tested and lab-confirmed negative and were counseled after self- and rapid tests. In total, 0.7% (3/451) of the participants who self-tested positive and were lab-confirmed positive were linked to a physician within the same day. Furthermore, 98.8% (417/422) of the participants found the app to be useful and 94.0% (424/451) were willing to recommend it to a friend or partner. CONCLUSIONS The HIVSmart! app-optimized strategy was feasible, accepted, and preferred by an educated, urban MSM population of Montreal. With the app, participants were able to perform, interpret, store results, and get rapidly linked to care. The HIVSmart!-optimized, self-testing strategy could be adapted and contextualized to many at-risk populations within Canada and worldwide, thereby maximizing its public health impact.

Feasibility of Indirect Secondary Distribution of HIV Self-Test Kits via WeChat Among Men Who Have Sex with Men: A National Cross-Sectional Study in China (Preprint)

2021 ◽  
Author(s):  
Li Shangcao ◽  
Jing Zhang ◽  
Xiang Mao ◽  
Tianyi Lu ◽  
Yangyang Gao ◽  
...  
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Sexual Partners ◽  
Cross Sectional ◽  
Self Testing ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Secondary Distribution ◽  
Self Test ◽  
Sex With Men

BACKGROUND The use of HIV self-test (HST) kits is commonplace in key sexually active populations. The direct secondary distribution of HST kits (DSDHK) is effective in improving the uptake of HIV self-testing. However, there are concerns about various limitations of DSDHK, including limited geographic location, payment problems, and face-to-face interaction. OBJECTIVE We evaluated the feasibility and characteristics of the indirect secondary distribution of HST kits (ISDHK) via WeChat (distributing HST application links and follow-up HST kits to partners) among men who have sex with men (MSM). METHODS From October 2017 to September 2019, an HIV self-testing (HIVST) recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for HST kits (referred to as “index participants” [Ips]). All of the MSM participants were encouraged to distribute the HST application link to their friends and sexual partners (referred to as “Alters”) through their social networks. All Alters were further encouraged to continue to distribute the HST application link. All participants paid a deposit (USD 7), refundable upon completion of the questionnaire and uploading of the test result via an online survey system. RESULTS 2,263 MSM met the criteria and successfully applied for HST. Of these, 1,816 participants returned their HST test results, including 1,422 (88.3%) IPs and 394 (21.7%) Alters. Compared with the IPs, the Alters practiced more condomless anal intercourse (CAI), a higher proportion of them never previously had an HIV test, and they had a greater willingness to distribute HST kits to sexual partners (all p < 0.05). After controlling for age, education, and income, the Alters had a greater proportion of MSM who had never tested for HIV before (aOR = 1.29, 95% CI 1.00–1.68), were more willing to distribute the HST application link (aOR = 1.71, 95% CI 1.21–2.40), had a lower number of sexual partners (aOR = 0.71, 95% CI 0.57–0.90), and were less likely to search for sexual partners via online means (aOR = 0.78, 95% CI 0.60–1.02). In comparison, the rates of reactive HST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy (ART) were similar for IPs and Alters. CONCLUSIONS The ISDHK mode of distributing HST application links via social media is feasible among the MSM population. The ISDHK mode should be used to supplement the DSDHK mode in order to enable a greater proportion of the MSM population to know their HIV infection status.

scholarly journals HIV testing practices and the potential role of HIV self-testing among men who have sex with men in Mexico

2016 ◽  
Vol 28 (3) ◽  
pp. 242-249 ◽  
Author(s):  
Catherine E Oldenburg ◽  
Katie B Biello ◽  
Amaya G Perez-Brumer ◽  
Joshua Rosenberger ◽  
David S Novak ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hiv Testing ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Intention To Use ◽  
Self Testing ◽  
Hiv Test ◽  
Self Test ◽  
Testing Practices ◽  
Sex With Men

The objective of this study was to characterize HIV testing practices among men who have sex with men in Mexico and intention to use HIV self-testing. In 2012, members of one of the largest social/sexual networking websites for men who have sex with men in Latin America completed an anonymous online survey. This analysis was restricted to HIV-uninfected men who have sex with men residing in Mexico. Multivariable logistic regression models were fit to assess factors associated with HIV testing and intention to use a HIV self-test. Of 4537 respondents, 70.9% reported ever having a HIV test, of whom 75.5% reported testing at least yearly. The majority (94.3%) indicated that they would use a HIV home self-test if it were available. Participants identifying as bisexual less often reported ever HIV testing compared to those identifying as gay/homosexual (adjusted odds ratio = 0.52, 95% confidence interval: 0.44–0.62). Having a physical exam in the past year was associated with increased ever HIV testing (adjusted odds ratio = 4.35, 95% confidence interval: 3.73–5.07), but associated with decreased interest in HIV self-testing (adjusted odds ratio = 0.66, 95% confidence interval: 0.48–0.89). The high intention to use HIV home self-testing supports the use of this method as an acceptable alternative to clinic- or hospital-based HIV testing.

HIV result giving. Is it time to change our thinking?

Sexual Health ◽  
2010 ◽  
Vol 7 (1) ◽  
pp. 8 ◽  
Author(s):  
Loretta M. Healey ◽  
Catherine C. O'Connor ◽  
David J. Templeton
Keyword(s):  
Health Policy ◽  
New South ◽  
Health Department ◽  
Health Clinic ◽  
Test Results ◽  
South Wales ◽  
Hiv Test ◽  
Number Of Patients ◽  
Post Test ◽  
Sydney Australia

Background: Ensuring patients receive post-test discussion when collecting HIV test results is an integral component of the HIV testing process. New South Wales Health Department (NSW Health) policy recommends that all patients be given their HIV results in person. We assessed the number of patients who returned for HIV test results to Royal Prince Alfred Sexual Health Clinic in Sydney, Australia, and predictors of return. Methods: The files of 218 patients having consecutive HIV tests from the beginning of January to the end of April 2007 were manually reviewed. Non-consenting patients and those returning to the clinic for another reason were excluded. Multivariate logistic regression was used to determine factors associated with return for HIV results in person within 4 weeks of having the test. Results: Seventy-two of 159 patients (45%) returned for their HIV result within 4 weeks of testing. Independent predictors of return were male gender (P = 0.041), attending the outreach men-only (v. base) clinic (P = 0.017), first HIV test at the clinic (P = 0.002) and sex overseas in the past year (P = 0.048). Conclusion: Over one-half of patients did not collect their HIV results in person and thus did not receive any post-test discussion. The strongest predictor of return for HIV test results was having a first HIV test at the clinic. Current NSW Health policy is failing to achieve high levels of HIV post-test discussion. For many patients, giving results by telephone may be a more appropriate strategy to ensure HIV post-test discussion.

scholarly journals Social Media–Based Secondary Distribution of Human Immunodeficiency Virus/Syphilis Self-testing Among Chinese Men Who Have Sex with Men

2020 ◽  
Author(s):  
Dan Wu ◽  
Yi Zhou ◽  
Nancy Yang ◽  
Shanzi Huang ◽  
Xi He ◽  
...  
Keyword(s):  
Social Media ◽  
Human Immunodeficiency Virus ◽  
Test Results ◽  
Self Testing ◽  
Immunodeficiency Virus ◽  
Secondary Distribution ◽  
Self Test ◽  
Sex With Men ◽  
Test Result ◽  
Unique Index

Abstract Background Social media and secondary distribution (distributing self-testing kits by indexes through their networks) both show strong promise to improve human immunodeficiency virus (HIV) self-testing uptake. We assessed an implementation program in Zhuhai, China, which focused on the secondary distribution of HIV/syphilis self-test kits among men who have sex with men (MSM) via social media. Methods Men aged ≥16 years, born biologically male, and ever had sex with another man were recruited as indexes. Banner ads on a social media platform invited the participants to apply for up to 5 self-test kits every 3 months. Index men paid a deposit of US$15/kit refundable upon submitting a photograph of a completed test result via an online submission system. They were informed that they could distribute the kits to others (referred to as “alters”). Results A total of 371 unique index men applied for 1150 kits (mean age, 28.7 [standard deviation, 6.9] years), of which 1141 test results were returned (99%). Among them, 1099 were valid test results; 810 (74%) were from 331 unique index men, and 289 tests (26%) were from 281 unique alters. Compared to index men, a higher proportion of alters were naive HIV testers (40% vs 21%; P &lt; .001). The total HIV self-test reactivity rate was 3%, with alters having a significantly higher rate than indexes (5% vs 2%; P = .008). A total of 21 people (3%) had a reactive syphilis test result. Conclusions Integrating social media with the secondary distribution of self-test kits may hold promise to increase HIV/syphilis testing coverage and case identification among MSM.

scholarly journals Feasibility of large-scale population testing for SARS-CoV-2 detection by self-testing at home

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paula Iruzubieta ◽  
Tatiana Fernández-Lanas ◽  
Laura Rasines ◽  
Lorena Cayon ◽  
Ana Álvarez-Cancelo ◽  
...  
Keyword(s):  
Large Scale ◽  
Rapid Test ◽  
The Self ◽  
Healthcare Personnel ◽  
Testing Strategy ◽  
Self Testing ◽  
Scale Population ◽  
Self Test ◽  
Test Result ◽  
At Home

AbstractThe simplicity and low cost of rapid point-of-care tests greatly facilitate large-scale population testing, which can contribute to controlling the spread of the COVID-19 virus. We evaluated the applicability of a self-testing strategy for SARS-CoV2 in a population-based, cross-sectional study in Cantabria, Spain, between April and May 2020. For the self-testing strategy, participants received the necessary material for the self-collection of blood and performance of a rapid antibody test using lateral flow immunoassay at home without the supervision of healthcare personnel. A total of 1,022 participants were enrolled. Most participants correctly performed the COVID-19 self-test the first time (91.3% [95% CI 89.4–92.9]). Only a minority of the participants (0.7%) needed the help of healthcare personnel, while 6.9% required a second kit delivery, for a total valid test result in 96.9% of the participants. Incorrect use of the self-test was not associated with the educational level, age over 65, or housing area. Prevalence of IgG antibodies against SARS-CoV2 for subjects with a valid rapid test result was 3.1% (95% CI 2.2–4.4), similar to the seroprevalence result obtained using a conventional approach carried out by healthcare professionals. In conclusion, COVID-19 self-testing should be considered as a screening tool.

scholarly journals Will an Unsupervised Self-Testing Strategy Be Feasible to Operationalize in Canada? Results from a Pilot Study in Students of a Large Canadian University

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Nitika Pant Pai ◽  
Madhavi Bhargava ◽  
Lawrence Joseph ◽  
Jigyasa Sharma ◽  
Sabrina Pillay ◽  
...  
Keyword(s):  
Willingness To Pay ◽  
The United States ◽  
Casual Sex ◽  
Health Clinic ◽  
Testing Strategy ◽  
Multiple Partners ◽  
Self Testing ◽  
History Of ◽  
At Risk Populations ◽  
Self Test

Background.A convenient, private, and accessible HIV self-testing strategy stands to complement facility-based conventional testing. Over-the-counter oral HIV self-tests are approved and available in the United States, but not yet in Canada. Canadian data on self-testing is nonexistent. We investigated the feasibility of offering an unsupervised self-testing strategy to Canadian students.Methods.Between September 2011 and May 2012, we recruited 145 students from a student health clinic of a large Canadian university. Feasibility of operationalization (i.e., self-test conduct, acceptability, convenience, and willingness to pay) was evaluated. Self-test conduct was computed with agreement between the self-test performed by the student and the test repeated by a healthcare professional. Other metrics were measured on a survey.Results.Participants were young (median age: 22 years), unmarried (97%), and 47% were out of province or international students. Approximately 52% self-reported a history of unprotected casual sex and sex with multiple partners. Self-test conduct agreement was high (100%), so were acceptability (81%), convenience (99%), and willingness to pay (74%) for self-tests. Concerns included accuracy of self-tests and availability of expedited linkages.Conclusion.An unsupervised self-testing strategy was found to be feasible in Canadian students. Findings call for studies in at-risk populations to inform Canadian policy.

scholarly journals AWARENESS AND WILLINGNESS TO PAY FOR HIV SELF-TEST AMONG MEN WHO HAVE SEX WITH MEN FROM METRO MANILA, PHILIPPINES

2020 ◽  
Vol 20 (1) ◽  
pp. 64-70
Author(s):  
Samuel Brando Piamonte ◽  
Rossana Ditangco
Keyword(s):  
Willingness To Pay ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Self Testing ◽  
Hiv Test ◽  
Test Kit ◽  
Metro Manila ◽  
Self Test ◽  
Sex With Men ◽  
Saliva Test

Self-testing is a new innovation in HIV testing where one can conduct an HIV test and interpret results discreetly. However, such is not yet available in the Philippine market. This formative study aims to identify the awareness of men who have sex with men (MSM) from Metro Manila, Philippines towards HIV self-testing (HIVST) as well as their willingness to pay for a self-test kit should it be available commercially. Two-hundred fifty MSM who received a non-reactive HIV screening test result from a community-based voluntary counseling and testing center were recruited. Results indicated that there were more respondents who have not heard yet about HIVST. The social media and the internet were the most prominent of source of awareness about it. Frequent testers and being exclusively or more attracted to the same sex are more likely to be aware of HIVST. Median price one is willing to pay is 500 Pesos (roughly 10 US Dollars) and preference for saliva test that blood was reported. Over-all, results implicate that efforts to inform MSM about HIVST should be initiated effectively. Should it be available, HIVST services can also be optimized if done through saliva test and are provided at low price.

HIV results by phone: can we predict who will test HIV-negative?

Sexual Health ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 417 ◽  
Author(s):  
Simon Wright ◽  
Nathan Ryder ◽  
Anna M. McNulty
Keyword(s):  
Risk Factors ◽  
Sexual Health ◽  
Health Centre ◽  
Sexual Partners ◽  
Health Clinic ◽  
Test Results ◽  
Face To Face ◽  
Hiv Test ◽  
Sex With Men ◽  
Pro Forma

Introduction: In order to review the requirement for all patients to return for HIV test results, we sought to describe the number of cases of HIV infection detected at Sydney Sexual Health Centre among people who did not disclose known risk factors before testing. Method: The clinic database identified all HIV testing episodes between January 2004 and January 2007, along with gender, gender of sexual partners and test result. Pro-forma medical records were reviewed for each person who tested positive for gender of sexual partners, condom use, and sexual contact with a person from a country known to have a high HIV prevalence and injecting drug use. Results: During the 3-year period, a total of 13 290 HIV tests were performed. In men who have sex with men, 6194 tests were performed and 55 (0.88%) tested positive. In women and heterosexual men 7096 tests were performed, and only four (0.06%) tested positive. All four reported known risks for HIV before testing. Conclusion: Clients with no recognised risk factors for HIV are unlikely to test positive at our Australian sexual health clinic. Providing the option for low risk people to obtain their results other than face to face has advantages for both the clinic in terms of service provision and the clients in terms of time and the proportion who receive their result.

scholarly journals The incorporation of HIV self-testing as an exclusive option among men who have sex with men in Spain: results of an online cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Hoyos ◽  
J. M. Guerras ◽  
K. Koutentakis ◽  
L. de la Fuente ◽  
J. Pulido ◽  
...  
Keyword(s):  
Online Survey ◽  
Linkage To Care ◽  
Care Process ◽  
Cross Sectional ◽  
Know How ◽  
The Past ◽  
Self Testing ◽  
Hiv Test ◽  
Self Test ◽  
Sex With Men

Abstract Background We assessed to what extent HIV self-testing would be incorporated by men who have sex with men (MSM) with previous testing history as their exclusive testing option and describe what actions they would take in the case of obtaining a reactive self-test. Methods We conducted an online survey among Spanish resident MSM recruited mainly in gay dating apps and analyze 6171 ever tested individuals. We used Poisson regression to estimate factors associated with the incorporation of self-testing as the exclusive testing option. Among those who would incorporate self-testing as their exclusive option, we described actions taken if obtaining a reactive self-test by number of tests in the past. Results Nearly half of the participants (48.3%) were > =35 years old, 84.6% were born in Spain, 57.9% had attained a university degree, 55.1% lived in a municipality of ≤500.000 and 86.4% self-identified as homosexual. For 37.2%, self-testing would become their exclusive testing option. The incorporation of self-testing as the exclusive option increased with age 25–34 (PR:1.1, 95%CI:1.0–1.3), 35–44 (PR:1.3, 95%CI:1.2–1.5), 45–49 (PR:1.5, 95%CI:1.3–1.7) and > 50 (PR:1.5, 95%CI:1.3–1.8) and in those who reported unprotected anal intercourse (PR:1.1, 95%CI:1.0–1.2) or having paid for sex (PR:1.2, 95%CI:1.0–1.3) in the last 12 months. It was also associated with having had < 10 HIV test in the past (2–9 tests (PR:1.3, 95%CI:1.1–1.4); 1 test (PR:1.5, 95%CI:1.3–1.7)), and having been tested ≥2 years (PR:1.4, 95%CI:1.3–1.5) or between 1 and 2 years ago (PR:1.1, 95%CI:1.0–1.2). Of participants who would use self-testing exclusively 76.6% would confirm their result in case of obtaining a reactive self-test and only 6.1% wouldn’t know how to react. Only one individual expressed that he would do nothing at all. Conclusion HIV self-testing could become the exclusive testing option for more than a third of our participants. It was chosen as the exclusive option especially by older, at risk and under-tested MSM. Self-testing strategies need to especially consider the linkage to care process. In this sense, only a small fraction would not know how to react and virtually nobody reported taking no action if obtaining a reactive result.

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