The acceptability and usability of two HIV self-test kits among men who have sex with men: a randomised crossover trial

Dana Y.L. Lee, Jason J. Ong*, Kirsty Smith, Muhammad S. Jamil, Ruthy McIver, Rebecca Wigan, Kate Maddaford, Anna McNulty, John M. Kaldor, Christopher K. Fairley, Benjamin Bavinton, Marcus Chen, Eric P.F. Chow, Andrew E. Grulich, Martin Holt, Damian P. Conway, Mark Stoove, Handan Wand, Rebecca J. Guy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objectives: To compare the usability and acceptability of oral fluid- and blood-based HIV self-test kits among men who have sex with men in Australia. Design: Randomised crossover trial. Setting, participants: Gay, bisexual, and other men aged 18 years or older who have sex with men, who attended two metropolitan sexual health clinics in Sydney and Melbourne, 7 January – 10 December 2019. Main outcome measures: Ease of use of HIV self-test kits; preferred HIV self-test type; difficulties encountered during HIV self-testing. Results: 170 men were recruited (median age, 34 years; interquartile range, 29–43 years); 144 identified as gay (85%), 96 were born outside Australia (57%). Participants were more likely to report the oral fluid HIV self-test was easy to use than the blood-based self-test (oral fluid, 99%; blood, 86%; odds ratio [OR], 3.0; 95% confidence interval [CI], 1.4–6.6). The oral fluid test was preferred by 98 participants (58%; 95% CI, 50–65%), the blood-based test by 69 (41%; 95% CI, 33–48%). Difficulties with the oral fluid test kit identified by observing nurses included problems placing the buffer solution into the stand (40 of 170 participants, 24%) and not swabbing both gums (23 of 169, 14%); difficulties with the blood-based test kit included problems filling the device test channel (69 of 170, 41%) and squeezing the finger firmly enough to generate a blood drop (42 of 170, 25%). No participant received an invalid result with the oral fluid self-test; two of 162 participants (1%) received invalid results with the blood self-test. After adjusting for age, education level, and ethnic background, characteristics associated with higher odds of using HIV self-testing in the future were overseas birth (adjusted OR, 3.07; 95% CI, 1.42–6.64), and self-evaluated ease of use and confidence in using the kits. Conclusion: It is important to provide options for obtaining both oral fluid- and blood-based HIV self-tests. The usability and acceptability of both kits were high, but the ease of use and perceived accuracy influenced test kit preference.

Original languageEnglish
Pages (from-to)149-154
Number of pages6
JournalMedical Journal of Australia
Volume217
Issue number3
DOIs
Publication statusPublished - 1 Aug 2022
Externally publishedYes

Bibliographical note

Funding Information:
The study was funded by the National Health and Medical Research Council (NHMRC) STI Program Grant (568971). Rebecca Guy is supported by an Australian NHMRC Research Fellowship (1124647); Dana Lee is supported by an Alfred Health and Central Clinical School Summer Scholarship; Jason Ong is supported by an NHMRC Investigator Grant (1193955); and Eric Chow is supported by an NHMRC Emerging Leadership Investigator Grant (1172873).

Funding Information:
We thank all study participants and the following people who assisted in making this investigation possible: Garrett Prestage (University of New South Wales, assisted with study design), Karl Johnson (ACON, assisted with recruitment) and Adam Hynes (Thorne Harbor Health, assisted with recruitment). All HIV self-test kits were provided free of charge by the manufacturers. The study was funded by the National Health and Medical Research Council (NHMRC) STI Program Grant (568971). Rebecca Guy is supported by an Australian NHMRC Research Fellowship (1124647); Dana Lee is supported by an Alfred Health and Central Clinical School Summer Scholarship; Jason Ong is supported by an NHMRC Investigator Grant (1193955); and Eric Chow is supported by an NHMRC Emerging Leadership Investigator Grant (1172873).

Publisher Copyright:
© 2022 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

Keywords

  • Diagnostic tests and procedures
  • HIV
  • Public health
  • Sexually transmitted diseases

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