title: Preparedness for use of the rapid result HIV self-test by gay men and other men who have sex with men (MSM): a mixed methods exploratory study among MSM and those involved in HIV prevention and care.
abstract: The aim of the study was to explore preparedness for the HIV self-test among men who have sex with men (MSM) and those involved in HIV prevention and care.
  
  
  
  A mixed methods exploratory research design was employed, detailing awareness and willingness to use the self-test and the perceived barriers and facilitators to implementation. Quantitative and qualitative data collection and analysis were completed in parallel. Descriptive and inferential analysis of cross-sectional bar-based survey data collected from MSM through a self-completed questionnaire and oral fluid specimen collection (n = 999) was combined with qualitative, thematic, analysis of data collected through 12 expert focus groups (n = 55) consisting of gay men, National Health Service (NHS) staff, community organizations, entrepreneurs and activists. Findings were subsequently combined and assessed for synergies.
  
  
  
  Among MSM, self-test awareness was moderate (55%). Greater awareness was associated with increased educational attainment [adjusted odds ratio 1.51; 95% confidence interval (CI) 1.00-2.30; P = 0.05] and previous history of sexually transmitted infection (STI) testing (adjusted odds ratio 1.63; 95% CI 1.11-2.39; P = 0.01). Willingness to use the test was high (89%) and associated with meeting sexual partners online (unadjusted odds ratio 1.96; 95% CI 1.31-2.94; P < 0.001). Experts highlighted the overall acceptability of self-testing; it was understood as convenient, discreet, accessible, and with a low burden to services. However, some ambivalence towards self-testing was reported; it could reduce opportunities to engage with wider services, wider health issues and the determinants of risk.
  
  
  
  Self-testing represents an opportunity to reduce barriers to HIV testing and enhance prevention and access to care. Levels of awareness are moderate but willingness to use is high. Self-testing may amplify health inequalities.
authors: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors: P
authors: P
authors: Flowers
authors: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
authors: J
authors: J
authors: Riddell
authors: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.|MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
authors: C
authors: C
authors: Park
authors: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors: B
authors: B
authors: Ahmed
authors: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
authors: I
authors: I
authors: Young
authors: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors: J
authors: J
authors: Frankis
authors: School of Social Sciences, Monash University, Melbourne, Vic., Australia.
authors: M
authors: M
authors: Davis
authors: Applied Epidemiology Unit, Ontario HIV Treatment Network, Toronto, ON, Canada.
authors: M
authors: M
authors: Gilbert
authors: Barts and the London School of Medicine and Dentistry, Barts Sexual Health Centre, Blizard Institute, London, UK.
authors: C
authors: C
authors: Estcourt
authors: Health Protection Scotland, Glasgow, UK.
authors: L
authors: L
authors: Wallace
authors: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
authors: L M
authors: LM
authors: McDaid
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis*; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D016353:Self-Examination / Q000379:methods*; D000072339:Sexual and Gender Minorities; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: HIV prevention; HIV testing; men who have sex with men; sexual health; sexual risk behaviour