Internet-Based HIV Self-Testing Among Men Who Have Sex With Men Through Pre-exposure Prophylaxis: 3-Month Prospective...

Area of Science:

• Public Health
• HIV Prevention
• Sexual Health

Background:

• Routine HIV testing alongside pre-exposure prophylaxis (PrEP) needs innovative support in real-world settings.
• Men who have sex with men (MSM) are a key population for HIV prevention strategies.

Purpose of the Study:

• To determine the usage and secondary distribution of HIV self-testing (HIVST) kits among MSM in China who are using PrEP.
• To assess the feasibility of providing HIVST kits to PrEP users in a real-world setting.

Main Methods:

• An observational study in 4 major Chinese cities from 2018-2019 involving MSM in the China Real-world oral PrEP demonstration study.
• Participants received daily or on-demand PrEP for 12 months, with half randomized to receive monthly HIVST kits in addition to facility-based testing.
• HIVST usage, secondary distribution, and ease of use were assessed via quarterly follow-ups.

Main Results:

• Out of 939 recruited MSM, 471 were randomized to receive HIVST. Among these, 74.5% used the kits, finding them easy to use.
• Over half (52.8%) of HIVST users distributed kits to other MSM. Among those who returned results, 51.6% used HIVST with partners.
• Daily PrEP users showed higher likelihood of HIVST usage (aHR=1.3) and distribution (aHR=1.3) compared to on-demand users.

Conclusions:

• MSM using PrEP demonstrated high rates of HIVST kit usage and secondary distribution, particularly those on daily PrEP.
• These findings suggest high feasibility and necessity for integrating HIVST into PrEP services.
• HIVST could potentially supplement or replace facility-based HIV testing for some individuals, pending availability of advanced test kits.