HIV and Syphilis Self-Testing to Support the Implementation of Patient-Delivered Partner Therapy for Bacterial...

Patient-delivered partner therapy (PDPT) is a presumptive treatment mechanism for sexual partners of patients diagnosed with chlamydia and/or gonorrhea; however, successful implementation to sexual minoritized men (SMM) is impeded by concerns about missed opportunities for HIV and syphilis testing. As such, we explored barriers and facilitators of including a dual HIV and syphilis self-testing device with PDPT among SMM residing in Oklahoma.

In 2023, in-depth interviews were conducted with HIV-negative or unknown status SMM ( n = 20; mean age, 33.4; 90% cisgender; 45% Black, Latino, or multiracial) eliciting responses about access to care, at-home HIV/sexually transmitted infection (STI) testing, and PDPT. Data were analyzed using the rigorous and accelerated data reduction technique.

Sexual minoritized men reported inadequate access to culturally competent providers. Despite mixed perceptions, altruism led most participants to indicate the importance of notifying a partner of a bacterial STI diagnosis. Delivering PDPT with an HIV and syphilis self-testing kit was perceived to increase confidentiality, improve access to appropriate care, decrease time to partner treatment, reduce exposure to antigay and HIV/STI stigmas, and avoid insurance and cost challenges. Participant intervention requests included the need for multimodal educational materials, a letter from a health care provider with contact information, medication and safety information, discrete packaging, and a communication guide.

Intervention requests by SMM will be important for maximizing successful uptake of PDPT with partner HIV and syphilis self-testing. Additional research with health care providers is needed to identify potential implementation strategies to support prescribing behaviors.