HIV self-testing feasible for many young MSM; May reduce disparities if access improves

HIV self-testing is a feasible option for many young men who have sex with men (MSM), a U.S. pilot study found. The researchers suggested that increased use of self-testing in this age group may improve health equity, although cost and parental consent requirements may be barriers.

About This Study

“A feasibility study of the use of HIV self-tests in young men who have sex with men” was published online on Jan. 6, 2023, in AIDS Care. The lead author is Rebecca Schnall, Ph.D., M.P.H. of Columbia University, New York, N.Y.

Key Research Findings

Study participants were drawn from the MyPEEPS Mobile HIV prevention trial, which involved 763 boys and men ages 13-18 years old. Participants in the current study were 14-21 years old by the time they were recruited. Those under age 17 years needed parental permission to participate because the test kit is not U.S.-approved for that age group.

During a video call with study staff, participants used the self-test kit and answered survey questions. Depending on the test result, either information on HIV prevention resources or linkage to HIV care for confirmatory testing was provided.

Of the MyPEEPS participants invited into this study, 253 agreed to enroll while 462 did not participate. The most common reasons for non-participation was not responding to contact attempts (308), while 90 youths said they were not interested. Four participants in the original study had since seroconverted. Not wanting to get parental permission and privacy concerns were also cited for declining participation, although there was no statistical difference in participation when age 17 was used as a binary variable.

People who spoke mostly Spanish at home were more likely to complete the pilot study than those whose primary home language was English. When age was used as a continuous variable, participants who were older were more likely to complete the study than those who were younger. Participants who identified as “mostly gay” were less likely to complete the study than those who identified as “only gay.”

Discussion Highlights and Implications for Practice

The researchers found the association between speaking Spanish at home and HIV self-testing uptake somewhat unexpected. They offered that Spanish speakers may have had difficulty finding testing services in that language. While having a primary care provider was not associated with uptake of HIV self-testing in this study, study authors theorized that perhaps those in Spanish-speaking homes were more likely to use self-testing because fewer reported having a primary care provider (63%, vs. 73% from English-speaking households).

The authors argued that further examination is also warranted in understanding why those who identify as “only gay” were more likely to participate than those who identify as mostly gay (bisexual). They suggested that bisexual participants may have believed that they were at lower risk of acquiring HIV than those who only had male sex partners.

In summary, the study authors concluded that at-home HIV tests may be helpful in reducing testing disparities among young MSM, although their price could be prohibitive for younger people. The age when parental consent is required for such tests should be examined to remove a potential barrier to testing, they added.

By Barbara Jungwirth