Men who have sex with men (MSM) are the group at highest risk for contracting human immunodeficiency virus (HIV) in the United States, but many do not test as frequently as recommended. Home-based self-testing (HBST) for HIV holds promise for promoting regular testing among these individuals, but currently available HBSTs have limited follow-up options, providing only a 1-800 number that participants can call. Failure to actively conduct follow-up counseling and referrals after HBST use could result in delays in seeking confirmatory testing and care among users receiving preliminary positive test results. HBST also fails to connect users who test negative with other prevention services that can reduce their future risk for HIV.
[Photo: Dr. Tyler Wray]
The aim of this study, led by Dr. Tyler Wray, assistant professor of behavioral and social sciences (Research), was to use qualitative research methods with high-risk MSM to inform development of a “smart” HBST kit. The kit utilizes existing Internet-of-Things technologies to monitor HBST use in real-time and enable delivery of timely, active follow-up counseling and referrals over the phone.
Phase 1 themes suggested that MSM preferred HBST, that most thought active follow-up after HBST would be valuable, and that doing so over the phone within 24 hours after testing was preferable. Phase 2 results showed that the eTEST system successfully detected HBST use in nearly all cases. Participant perspectives also suggested that the timing, method, and duration of follow-up were appropriate and helpful.
Using Bluetooth low energy beacons and a smartphone app to enable follow-up counseling and referral over the phone after HBST use is feasible and acceptable to high-risk MSM. Future research is needed to compare the effects of follow-up counseling on rates of repeat testing and receipt of referral services (eg, testing for sexually transmitted infections and initiation of preexposure prophylaxis) and to explore the acceptability of the eTEST system over longer periods of time.
This study was published in JMIR mHealth and uHealth, Vol 5, No 5, 2017.
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