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Value of HIV self-testing for high-risk men who have sex with men

May 19, 2017

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A key aspect of preventing HIV is to frequently test high risk individuals. The authors were interested if HIV self-testing would increase the frequency of testing in high-risk men who have sex with men (MSM). They performed a randomised trial in which HIV-negative high-risk men who reported condomless anal intercourse or more than five male sexual partners in the past 3 months were recruited. 182 men were randomly assigned to the intervention (free HIV self-testing plus facility-based testing) and 180 to standard care (facility-based testing only). The analysis population included 178 (98%) men in the self-testing group (174 person-years) and 165 (92%) in the standard care group (162 person-years). Overall, the men in the self-testing group underwent 701 HIV tests (410 self-tests, mean 4 tests per year), and men in the standard care group underwent 313 HIV tests (mean 1·9 tests per year). Therefore significantly more men in the intervention arm underwent testing (rate ratio [RR] 2·08, 95%CI 1·82–2·38). Among men tested in the previous 2 years, men in the self-testing group had 627 tests (356 self-tests, mean 4·2 per year), and men in the standard care group had 297 tests (mean 2·1 per year); RR 1·99 (95%CI 1·73-2·29). Among men tested over 2 years ago, men in the self-testing group had 74 tests (54 self-tests, mean 2·8 per year), and men in the standard care group had 16 tests (mean 0·7 per year); RR 3·95 (95%CI 2·30-6·78). Therefore HIV self-testing results in a twofold increase in the frequency of testing in MSM  at high risk of infection overall, and a nearly fourfold increase in non-recent testers.

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Jamil MS, Prestage G, Fairley CK, Grulich AE, Smith KS, et al. ISSN: Lancet HIV; pii: S2352-3018(17)30023-1

2017

Added: May 19, 2017