Acceptability, Barriers, and Facilitators to Home-Based Syphilis Self-testing: A Scoping Review

Area of Science:

• Public Health
• Infectious Diseases
• Sexual Health

Background:

• Syphilis is a persistent global health issue requiring effective prevention and early detection strategies.
• Clinic-based syphilis testing faces challenges including stigma, accessibility, and procedural delays.
• Home-based syphilis self-testing offers a promising alternative to improve testing access.

Purpose of the Study:

• To synthesize evidence on the acceptability, barriers, and facilitators of home-based syphilis self-testing.
• To identify research gaps in the literature on syphilis self-testing.
• To inform strategies for expanding syphilis testing uptake.

Main Methods:

• A systematic scoping review of peer-reviewed studies published between 2001 and 2025.
• Searches conducted in PubMed, CINAHL, Embase, and Scopus databases.
• Thematic analysis guided by the socio-ecological model.

Main Results:

• Home-based syphilis self-testing demonstrated general acceptability across diverse populations and settings.
• Key barriers included difficulty with finger-prick blood sampling, low risk perception, and knowledge gaps.
• Facilitators comprised enhanced privacy, convenience, rapid results, and prior testing experience.

Conclusions:

• Home-based syphilis self-testing has significant potential to increase syphilis testing rates and facilitate early detection.
• Addressing individual-level barriers, such as blood sampling, is crucial for wider adoption.
• Further research and supportive strategies are needed to integrate home-based syphilis self-testing into real-world healthcare settings.