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The impact of HIV self-testing among internet-recruited men who have sex with men, eSTAMP 2015-2016


Author
MacGowan et al.

Publication year
2017

Country
USA

Type of approach
Community-based

Type of assistance
Unassisted

Specimen
Fingerstick/whole blood, Oral-fluid

Study population
Key population

Study design
Trials

Sample size
2665

UNAIDS HIV prevalence (2017)
0.2 [0.2 - 0.2]

Methodology
From Mar to Aug 2015, men who have sex with men (MSM) were recruited and enrolled into the eSTAMP randomised controlled trial. Participants were asked to complete online surveys at baseline, 3, 6, 9, and 12 months. The intervention group was mailed 4 rapid diagnostic tests (RDTs) at baseline with the option of replenishing the ones used after interim assessments. At the end of the study, all participants who completed the 12-month survey were mailed 2 RDTs and a dried blood spot card. Study outcomes: percentage of participants who tested 3 or more times, mean number of HIV tests, percentage who accessed clinic-based HIV testing services, mean number of sex partners in past 12-months, and newly identified HIV-positive cases by intervention and control group. 1325 MSM assigned to HIV self-testing intervention and 1340 assisgned to control.

Summary of findings
Mean age was 30.4 years; 58% were white, 10% black, 23% Hispanic, and 9% other or mixed race; 17% had never been tested for HIV. 72% completed at least one follow-up survey; retention rate at 12 months was 58%. In the HIVST arm, there was significantly more: newly identified HIV cases (2.6% vs 1.2%), frequent testing (79% vs 22%), and mean number of HIV tests (3.6 vs 1.8). There were fewer clinic-based HIV tests in the HIVST group (41% vs 64%). There was no significant difference between the mean number of sexual partners in each group (HIV testing in the HIV self-testing group (17.0 vs 19.7, p= 0.57).

Acceptability
n/a

Acceptability details
n/a

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
n/a

Specificity
n/a

Concordance
n/a

HIV positivity
2.6% (25/966)

Accuracy details
n/a

Social harm
No increase in mean number of sexual partners 9.1 (17.0) vs 9.7 (19.7) p=0.57

Linkage to prevention, care and treatment
Overall 21 people linked to care. Unclear how many were in HIV self-test arm and how many were in control arm.


Study status
Completed