Objectives Self-tests are performed and interpreted autonomously by a person without involving a healthcare professional or a certified laboratory. To gain insight into the usage of purchased HIV self-tests (HIVST) among migrants living in high-income countries, we studied the prevalence and determinants of HIVST usage among migrants living in the UK, France and the Netherlands.
Methods We used web-based questionnaire data collected between April 2014 and July 2015 among migrants living in the UK, France and the Netherlands who participated in the cross-sectional community survey of the aMASE (advancing Migrant Access to health Services in Europe) study. HIVST usage in the preceding 12 months and the corresponding 95% CIs were calculated. Using univariate logistic regression analyses, determinants of HIVST usage were evaluated.
Results Among 477 migrants living in the UK (n=235), France (n=98) and the Netherlands (n=144), HIVST usage in the preceding 12 months was 1.89% (9/477, 95% CI 0.66% to 3.11%). As all nine HIVST users were men who have sex with men (MSM), we restricted our univariate analyses to MSM (n=240). HIVST usage was borderline significantly lower among MSM living in France and the Netherlands compared with those living in the UK (UK: reference; France: OR 0.20, 95% CI 0.03 to 1.14; the Netherlands: OR 0.06, 95% CI 0.00 to 1.05). Age, region of birth, educational level, registration at a general practitioner, recent number of male sexual partners and hard drug use were not associated with HIVST usage among MSM.
Conclusions HIVST usage among migrants from the UK, France and the Netherlands was relatively low between 2014 and 2015 but higher among migrant MSM. To increase HIV testing rates among migrants, programmes need to be developed to promote HIVST among this group. Also, as more countries approve usage of HIVST, systems need to be established to ensure linkage to confirmatory testing and care following a positive test.
- HIV infections
- Transients and Migrants
- Cross-Sectional Studies
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Handling editor Jackie A Cassell
Contributors JPB interpreted the data and wrote the draft of the manuscript. JPB, FRZ and MP designed this study on self-testing, and FRZ and MP supervised the analyses and interpretation of the data. FB led the design and implementation of the European aMASE study. IF coordinated the European aMASE study. AV-A was responsible for the data collection in France. All authors provided substantial contribution to the interpretation of the data and to subsequent drafts, and approved the final version of the manuscript.
Funding The aMASE study is part of the Work Package 14 of EuroCoord, which is funded by the EU’s Seventh Framework Programme for research, technological development and demonstration (EuroCoord grant no 260694). Additional funding for the analyses of the present study was received from the Public Health Service of Amsterdam’s Research and Development Fund (project no 12-29).
Competing interests MP and FRZ have received non-financial support (ie, HIVST kits) from OraSure Technologies for another investigator-initiated study concerning HIV self-testing. FB has received conference support and consultancy fees from Gilead Sciences.
Patient consent Not required.
Ethics approval Ethical approval was obtained from the London-Bentham Research Ethics Committee (11/LO/1600) and the ethics committee of the Academic Medical Center/University of Amsterdam (2013_137#C20131038).
Provenance and peer review Not commissioned; externally peer reviewed.