Distribution of HIV self-tests by men who have sex with men attending a French sexual health centre: results of the OTO study

Abstract

Objectives: HIV self-tests (HSTs) have been deployed to reduce the burden of undiagnosed HIV infections in subpopulations undertested. We assumed that patients attending sexual health centres could themselves distribute HSTs in their close network. This study aimed to assess the proportion and the characteristics of the participants who distributed HSTs, as well as the characteristics of people who received HSTs.

Methods: Three HSTs were given to patients attending "Le 190" Sexual Health Center, Paris, France, having consented for the study, between July 2018 and August 2020. Participants had to distribute HSTs within 6 months, preferably to individuals in their close circle who have not been tested for a long time. Then they had to complete a self-questionnaire, exploring HIV status, sexual practices, number of distributed HSTs, profile of persons who received HSTs, and if known, result of used HSTs. Univariable logistic regression was used to determine factors associated with HST distribution.

Results: Overall, 682/1062 (64%) patients accepted to be included in the study, and 283/682 (42%) completed the questionnaire. 97% were men who have sex with men (MSMs), including 86 (30%) HIV-positive individuals and 119 (42%) HIV Pre-Exposure Prophylaxis (PrEP) users. The proportion of participants having distributed 0, 1, 2 or 3 HSTs was 31%, 15%, 27% and 27%, respectively. Participants having distributed at least one HST (n=195, 69%) were more likely to have previously used HSTs themselves (OR=3.90, 95% CI=1.84 to 8.29, p<0.001). On the 901 HSTs in possession of participants who answered the questionnaire, 455 (50%) were distributed. 79% of recipients were MSMs, and 42% of whom had not been tested for more than 1 year. The result was known for 220 HSTs, including 5 positive (2.3%).

Conclusion: MSMs attending sexual health centres could be good disseminators of HSTs, targeting a population with high level of undiagnosed HIV infections, especially if they have already experimented it.

Keywords: HIV; Homosexuality, Male; Point-of-Care Testing.