HIV home testing in Poland - an underappreciated approach despite huge potential : an implementation study

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Prevention

Background:

• HIV testing accessibility is limited in Poland, with services concentrated in large cities.
• Traditional testing venues (VCTs, clubs) fail to reach geographically dispersed populations.
• New approaches are needed to overcome barriers in HIV screening, especially in Europe.

Purpose of the Study:

• To evaluate the potential of free HIV home-test distribution to bridge testing gaps in Poland.
• To assess the uptake and characteristics of individuals utilizing opportunistic HIV home testing.
• To identify barriers and facilitators for HIV home testing among different demographic groups.

Main Methods:

• Free Simplitude ByMe HIV home-tests were distributed via parcel lockers from November 2022 to February 2023.
• Orders were placed opportunistically through the TyToTu.pl webpage.
• Participants completed pre-distribution questionnaires on demographics and prior testing, and post-distribution e-feedback.

Main Results:

• 1473 home tests were dispensed; 887 returned questionnaires were analyzed.
• The majority of recipients (57%) resided in large provincial cities; 80% reported it was their first HIV test.
• HIV prevalence was 0.34% (5 positive tests), all among heterosexual clients. Home testing uptake was lower than expected, with persistent barriers for heterosexual individuals.

Conclusions:

• HIV home testing in Poland is underutilized despite considerable interest, indicating unmet needs.
• Free availability of HIV home tests is recommended, particularly for heterosexual individuals, older adults, and immigrants.
• Increased funding and strategic implementation of home testing programs are crucial for early HIV diagnosis and treatment linkage.