Zhang, Ye; Jamil, Muhammad S; Smith, Kirsty S; Applegate, Tanya L; Prestage, Garrett; Holt, Martin; Keen, Phillip; Bavinton, Benjamin R; Chen, Marcus; Conway, Damian P; +11 more... Wand, Handan; McNulty, Anna M; Russell, Darren; Vaughan, Matthew; Batrouney, Colin; Wiseman, Virginia; Fairley, Christopher K; Grulich, Andrew E; Law, Matthew; Kaldor, John M; Guy, Rebecca J; (2021) The longer-term effects of access to HIV self-tests on HIV testing frequency in high-risk gay and bisexual men: follow-up data from a randomised controlled trial. The Lancet regional health. Western Pacific, 14. 100214-. ISSN 2666-6065 DOI: https://doi.org/10.1016/j.lanwpc.2021.100214
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Abstract
BACKGROUND: A wait-list randomised controlled trial in Australia (FORTH) in high-risk gay and bisexual men (GBM) showed access to free HIV self-tests (HIVSTs) doubled the frequency of HIV testing in year 1 to reach guideline recommended levels of 4 tests per year, compared to two tests per year in the standard-care arm (facility-based testing). In year 2, men in both arms had access to HIVSTs. We assessed if the effect was maintained for a further 12 months. METHODS: Participants included GBM reporting condomless anal intercourse or > 5 male partners in the past 3 months. We included men who had completed at least one survey in both year 1 and 2 and calculated the mean tests per person, based on the validated self-report and clinic records. We used Poisson regression and random effects Poisson regression models to compare the overall testing frequency by study arm, year and testing modality (HIVST/facility-based test). FINDINGS: Overall, 362 men completed at least one survey in year 1 and 343 in year 2. Among men in the intervention arm (access to HIVSTs in both years), the mean number of HIV tests in year 2 (3⋅7 overall, 2⋅3 facility-based tests, 1⋅4 HIVSTs) was lower compared to year 1 (4⋅1 overall, 1⋅7 facility-based tests, 2⋅4 HIVSTs) (RR:0⋅84, 95% CI:0⋅75-0⋅95, p=0⋅002), but higher than the standard-care arm in year 1 (2⋅0 overall, RR:1⋅71, 95% CI:1⋅48-1.97, p<0⋅001). Findings were not different when stratified by sociodemographic characteristics or recent high risk sexual history. INTERPRETATION: In year 2, fewer HIVSTs were used on average compared to year 1, but access to free HIVSTs enabled more men to maintain higher HIV testing frequency, compared with facility-based testing only. HIV self-testing should be a key component of HIV testing and prevention strategies. FUNDING: This work was supported by grant 568971 from the National Health and Medical Research Council of Australia.
Item Type | Article |
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Faculty and Department | Faculty of Public Health and Policy > Dept of Global Health and Development |
PubMed ID | 34671752 |
Elements ID | 199610 |
Official URL | http://dx.doi.org/10.1016/j.lanwpc.2021.100214 |
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Filename: Zhang-etal-2021-The-longer-term-effects-of-access-to-HIV-self-tests-on-HIV-testing-frequency-in-high-risk-gay-and-bisexual-men-follow-up-data-from-a-randomised-controlled-trial.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
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