20th International AIDS Conference - Melbourne, Australia


WEAX0105LB - Oral Abstract

Testing history and risk behaviour of individuals requesting an HIV test through an online self-sampling service

Presented by Rosemary Gillespie (United Kingdom).

S.J. Westrop1, C. James2, D. Edwardes2, M. Brady2, R. Gillespie2, O.N. Gill1, A. Nardone1

1Public Health England, HIV and STI Department, London, United Kingdom, 2Terrence Higgins Trust, London, United Kingdom

Background: A national online self-sampling service for HIV testing offered dried blood-spot kits to communities with the highest prevalence of undiagnosed HIV infection in England: men who have sex with men (MSM) and black African heterosexuals.
Methods: Clients ordering kits from 27/02/14-14/03/14 provided demographic, HIV testing and sexual behaviour information. Data were analysed to determine whether the service reached those at high-risk, not otherwise accessing HIV testing. We are yet to link this to HIV test outcome. Pearson''s χ2 test determined associations (STATA13).
Results: Throughout the 16 day study 3522 self-sampling kits were ordered; 94% by MSM (n=3321). Of kits ordered by heterosexuals (3.9%; men=58, women=79), the majority were ordered by clients of black African (86%; n=118), and mixed, white and black African (10%) ethnicities. A third of MSM reported never before testing (33%; n=1088); 41% testing over a year ago; and a quarter testing within the last year. In contrast, 40% (n=45) of black African heterosexuals had never before tested (men=41%, women=40%); 47% testing over a year ago (men=45%, women=49%); and only an eighth testing within the last year (men=14%, women=11%). A large proportion of clients reported unprotected sexual intercourse with ≥2 partners within the last 12 months (MSM=44%, black African heterosexuals=41%). Of those who had never before tested, 47% of both MSM and black African heterosexuals reported unprotected sex with ≥2 partners within the last year. Eight percent of MSM reported having sex under the influence of alcohol or drugs most of the time or always and unprotected sex with ≥2 partners within the last year. MSM reporting more sexual partners tested more recently (χ2=123.80, p< 0.001). The opposite was true of black African heterosexuals; those who reported more sexual partners were less likely to have tested recently (χ2=9.61; p=0.047).
Conclusions: The self-sampling service successfully recruited MSM and black African heterosexuals at high-risk who had not tested for HIV as frequently as recommended in national guidelines; many never testing before. This self-sampling service represents a novel, effective method of expanding HIV testing to individuals at high-risk of infection, who otherwise may not test in existing clinic/community-based settings.

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