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. 2021 Aug 16;16(8):e0256094.
doi: 10.1371/journal.pone.0256094. eCollection 2021.

Uptake of oral fluid-based HIV self-testing among men who have sex with men and transgender women in Thailand

Philippe Girault  1 , Christina Misa Wong  2 , Siroat Jittjang  1 , Kangwan Fongkaew  3 , Michael M Cassell  4 , Cheewanan Lertpiriyasuwat  5 , Ravipa Vannakit  4 , Matthew Avery  1 , Danai Linjongrat  6 , Saman Sumalu  7 , Somchai Phromsombat  8 , Nuttakrit Mainoy  9 , Pongpeera Patpeerapong  10 , Phonpiphat Potasin  11 , Pornpichit Brutrat  12 , Stephen Mills  1 , Nittaya Phanuphak  13   14 , Praphan Phanuphak  14
Affiliations

Uptake of oral fluid-based HIV self-testing among men who have sex with men and transgender women in Thailand

Philippe Girault et al. PLoS One. .

Abstract

Background: Suboptimal uptake of HIV testing remains a primary bottleneck to HIV prevention and treatment for men who have sex with men (MSM) and transgender women (TGW) in Thailand. The World Health Organization has recommended HIV self-testing (HIVST) as an additional strategic HIV service. However, HIVST has not been fully endorsed and implemented in many countries in Southeast Asia. The aim of this study was to assess the uptake of oral fluid-based HIVST in MSM and TGW populations in Thailand.

Methods: During 2017 and 2018, we conducted a cross-sectional study using convenience sampling to enroll 2,524 participants from three major urban areas. Participants were recruited during outreach and online activities and were offered unassisted or assisted HIVST, or referral to HIV testing services. A descriptive analysis was performed for summarizing data.

Results: A total of 2,502 participants (1,422 MSM and 1,082 TGW) were included in the analysis with about one-third (36.1%) of them being first-time testers. Among all participants enrolled in the study, a total of 2,486 participants (99.3%) selected HIVST versus referral to HIV testing services. Of those who selected HIVST, 2,095 (84.3%) opted for assisted HIVST while the rest opted for unassisted HIVST: 1,148 of 1,411 MSM (81.4%) and 947 of 1,075 TGW (88.1%) selected assisted HIVST. While no serious adverse events were reported during the study, we found that among 179 participants who needed a confirmatory test and were referred to HIV testing services, 108 (60.3.4%) accessed these later services.

Conclusions: This study demonstrated a high uptake of oral fluid-based HIVST among MSM and TGW populations in Thailand and that HIVST could be scaled up through the national epidemic control program. However, a better understanding of HIV testing-seeking behavior and innovative follow-up solutions are needed to improve and monitor linkages to services for people who undertake HIVST.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: MMC was an employee of and received direct support in form of salaries from the funding agency at the time of the conceptualization and methodology of the study. RV was an employee of and received direct support in form of salaries from the funding agency at the time of the conceptualization, methodology and supervision of the study. PG operated a sole proprietorship in France at the time of writing the original draft and reviewing and editing the manuscript and received consultancy fees from the funding agencies through the LINKAGES project. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials. RV operated a sole proprietorship in Thailand at the time of reviewing and editing the manuscript but did not receive any consultancy fees from the funding agency for this work. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials. The other co-authors have declared that no competing interests exists.

Figures

Fig 1
Fig 1. Willingness to pay for HIVST among potential MSM and TGW users.
See this image and copyright information in PMC

References

    1. Beyrer C, Sullivan P, Sanchez J, Baral SD, Collins C, Wirtz AL, et al. The increase in global HIV epidemics in MSM. AIDS. 2013;27: 2665–2678. doi: 10.1097/01.aids.0000432449.30239.fe - DOI - PubMed
    1. Baral SD, Poteat T, Strömdahl S, Wirtz AL, Guadamuz TE, Beyrer C. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13: 214–222. doi: 10.1016/S1473-3099(12)70315-8 - DOI - PubMed
    1. van Griensven F, Thienkrua W, McNicholl J, Wimonsate W, Chaikummao S, Chonwattana W, et al. Evidence of an explosive epidemic of HIV infection in a cohort of men who have sex with men in Bangkok, Thailand. AIDS. 2013;27(5): 825–32. doi: 10.1097/QAD.0b013e32835c546e - DOI - PubMed
    1. Guadamuz T, Wimonsate W, Varangrat A, Phanuphak P, Jommaroeng R, McNicholl J, et al. HIV prevalence, risk behavior, hormone use and surgical history among transgender persons in Thailand. AIDS Behav. 2011;15: 650–8. doi: 10.1007/s10461-010-9850-5 - DOI - PMC - PubMed
    1. Hull MW, Wu Z, Montaner JSG. Optimizing the engagement of care cascade. Curr Opin HIV AIDS. 2012;7: 579–586. doi: 10.1097/COH.0b013e3283590617 - DOI - PubMed

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