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. 2019 Aug 1;21(8):e14145.
doi: 10.2196/14145.

An Internet-Based HIV Self-Testing Program to Increase HIV Testing Uptake Among Men Who Have Sex With Men in Brazil: Descriptive Cross-Sectional Analysis

Raquel Brandini De Boni  1 , Valdilea Gonçalves Veloso  1 , Nilo Martinez Fernandes  1 , Flavia Lessa  1 , Renato Girade Corrêa  2 , Renato De Souza Lima  2 , Marly Cruz  3 , Juliane Oliveira  4 , Simone Muniz Nogueira  4 , Beto de Jesus  3 , Toni Reis  5 , Nena Lentini  6 , Raquel Lima Miranda  6 , Trista Bingham  7 , Cheryl C Johnson  8 , Aristides Barbosa Junior  6 , Beatriz Grinsztejn  1
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An Internet-Based HIV Self-Testing Program to Increase HIV Testing Uptake Among Men Who Have Sex With Men in Brazil: Descriptive Cross-Sectional Analysis

Raquel Brandini De Boni et al. J Med Internet Res. .

Abstract

Background: Approximately 30% of people living with HIV worldwide are estimated to be unaware of their infection. HIV self-testing (HIVST) is a strategy recommended by the World Health Organization to increase access to and uptake of testing among key populations who are at high risk for HIV infection.

Objective: This study aimed to describe the development and feasibility of a free, anonymous, internet-based HIVST strategy designed for men who have sex with men in Curitiba, Brazil (electronic testing [e-testing]).

Methods: The project was developed under the scope of the "A Hora é Agora" (The Time is Now) program. Individuals aiming to request an HIVST package (two tests each) answered an anonymous 5-minute questionnaire regarding inclusion criteria and sexual risk behavior. Eligible individuals could receive one package every 6 months for free. Website analytics, response to online questionnaires, package distribution, and return of test results were monitored via a platform-integrated system.

Results: Between February 2015 and January 2016, the website documented 17,786 unique visitors and 3218 completed online questionnaires. Most individuals self-reported being white (77.0%), young (median age: 25 years, interquartile range: 22-31 years), educated (87.3% completed secondary education or more), and previously tested for HIV (62.5%). Overall, 2526 HIVST packages were delivered; of those, 542 (21.4%) reported a result online or by mail (23 reactive and 11 invalid). During the study period, 37 individuals who reported using e-testing visited the prespecified health facility for confirmatory testing (30 positive, 7 negative).

Conclusions: E-testing proved highly feasible and acceptable in this study, thus supporting scale-up to additional centers for men who have sex with men in Brazil.

Keywords: HIV self-testing; HIV/AIDS; key populations; men; mobile health.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Sample of the “A Hora é Agora” communications strategy for Curitiba, Brazil (2015-2016).
Figure 2
Figure 2
E-testing Web platform: general information module.
Figure 3
Figure 3
E-testing Web platform: risk assessment calculator.
Figure 4
Figure 4
E-testing project flowchart for Curitiba, Brazil (2015-2016). *Between March 7, 2015, and May 4, 2015, and between August 14, 2015, and February 29, 2016, only one HIVST was sent in each package; therefore, the total number of unique HIVST kits distributed is 4342. HIVST: HIV self-testing.
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