title: HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women.
abstract: HIV status awareness is key to prevention, linkage-to-care and treatment. Our study evaluated the accessibility and potential willingness of HIV self-testing among men who have sex with men (MSM) and transgender women in Peru. We surveyed four pharmacy chains in Peru to ascertain the commercial availability of the oral HIV self-test. The pharmacies surveyed confirmed that HIV self-test kits were available; however, those available were not intended for individual use, but for clinician use. We interviewed 147 MSM and 45 transgender women; nearly all (82%) reported willingness to perform the oral HIV self-test. However, only 55% of participants would definitely seek a confirmatory test in a clinic after an HIV-positive test result. Further, price may be a barrier, as HIV self-test kits were available for 18 USD, and MSM and transgender women were only willing to pay an average of 5 USD. HIV self-testing may facilitate increased access to HIV testing among some MSM/transgender women in Peru. However, price may prevent use, and poor uptake of confirmatory testing may limit linkage to HIV treatment and care.
authors.affiliation: 1 Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Bustamante
authors.affiliation: 1 Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru.|2 Division of Infectious Diseases, Department of Medicine, University of California Los Angeles, Los Angeles CA, USA.
authors.forename: Kelika A
authors.initials: KA
authors.lastname: Konda
authors.affiliation: 3 Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Dvora
authors.initials: D
authors.lastname: Joseph Davey
authors.affiliation: 1 Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Segundo R
authors.initials: SR
authors.lastname: León
authors.affiliation: 1 Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru.|4 Epicentro Salud, Lima, Peru.
authors.forename: Gino M
authors.initials: GM
authors.lastname: Calvo
authors.affiliation: 5 Barton Health Center, Health Directorate of Callao, Lima, Peru.
authors.forename: Javier
authors.initials: J
authors.lastname: Salvatierra
authors.affiliation: 6 Center for Healthy Communities, Division of Clinical Sciences, UCR School of Medicine, Riverside, CA USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Brown
authors.affiliation: 1 Unit of Health, Sexuality and Human Development, and Laboratory of Sexual Health, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Caceres
authors.affiliation: 2 Division of Infectious Diseases, Department of Medicine, University of California Los Angeles, Los Angeles CA, USA.|3 Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods / Q000706:statistics & numerical data*; D000328:Adult; D000554:Ambulatory Care Facilities; D003266:Continuity of Patient Care; D059026:Diagnostic Self Evaluation; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010568:Peru; D011933:Reagent Kits, Diagnostic / Q000600:supply & distribution*; D012648:Self Care / Q000379:methods* / Q000523:psychology; D063106:Transgender Persons / Q000523:psychology
chemical_list: D011933:Reagent Kits, Diagnostic
keywords: HIV; Peru; homosexual; self-testing; transgender women
references.citation: Lancet. 2009 Jan 3;373(9657):48-57
references.pmid: 19038438
references.citation: Ann Emerg Med. 2011 Jul;58(1 Suppl 1):S74-8
references.pmid: 21684413
references.citation: BMC Public Health. 2013 Aug 08;13:735
references.pmid: 23924387
references.citation: BMC Infect Dis. 2013 Sep 10;13:426
references.pmid: 24016185
references.citation: AIDS Behav. 2014 Dec;18(12):2485-95
references.pmid: 24858480
references.citation: Lancet. 2015 Jan 17;385(9964):274-86
references.pmid: 25059941
references.citation: Med J Aust. 2015 Mar 16;202(5):251-5
references.pmid: 25758695
references.citation: J Int AIDS Soc. 2015 Mar 20;18:19445
references.pmid: 25797344
references.citation: Am J Public Health. 2015 Jul;105 Suppl 3:S449-52
references.pmid: 25905841
references.citation: Int J STD AIDS. 2016 Jun;27(7):531-6
references.pmid: 25971262