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Expanding HIV self-testing through pharmacies in Bangkok, Thailand: a demonstration project
Cheewanan Lertpiriyasuwat1, Prin Visavakum2, Thitiwat Puangmalee2
1Division of AIDS and STIs, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
Introduction:
Thai men who have sex with men (MSM) have faced a notable increase in HIV prevalence, yet access to HIV testing remains low. The Thai Ministry of Public Health launched a demonstration project to assess the feasibility and acceptability of private pharmacy-based HIV self-testing (HIVST) to enhance HIV testing uptake.
Methods:
Between August 2020 and August 2022, MSM aged 18 years and above, residing or working in greater Bangkok, and reporting unprotected sex in the past three months were eligible to participate, and recruited through MSM social media platforms. An online platform facilitated informed consent, a baseline questionnaire, and access to online HIVST tutorials. Participants received a free OraQuick® HIV test from one of 36 retail pharmacies, self-administered the test, and were advised to confirm positive results at public health facilities. Participants who collected a self-test kit received a follow-up questionnaire link, with a counseling hotline available as needed.
Results:
Among 1490 participants who collected HIVST kits, 618 (41.5%) completed both baseline and follow-up questionnaires. Of these, 278 (45.0%) were 25-34 years old and 303 (49.0%) were first-time testers. Most (499/618, 80.7%) reported having sex with men in the past three months, with 40.3% (201/499) not using condoms. Of the 562 (91.0%) who used the distributed HIVST kits, 14 (2.5%) reported reactive results. Among them, 8 (57.1%) sought confirmatory testing at a health facility. Most participants (495/562, 88.1%) reported moderate to high overall satisfaction, including 267/291 (91.8%) repeat and 228/271 (84.1%) first-time testers (p < .01), 523/562 (93.1%) intended to continue using HIVST, and 259/479 (54.1%) preferred retail pharmacies for distribution.
Conclusion:
This first pharmacy-based HIVST initiative, led by the Thai government in collaboration with private pharmacies, demonstrated strong feasibility, with 91% of participants using the distributed HIVST kits, and high acceptability, with 88.1% reporting moderate to high overall satisfaction. These findings underscore the potential of pharmacy-based HIVST among MSM in an urban Thai setting and highlight its promise for expanding HIV testing services in Thailand.
