Background Despite public-health efforts, men who have sex with men (MSM) are still not sufficiently reached with current HIV/STI care. We developed a regional MSM home-care program, used by public-health STI care, hospital HIV care, and general practitioners. The program combines home-based self-sampling testing for HIV, syphilis, chlamydia and gonorrhoea (anorectal, genital and oropharyngeal) with counselling, treatment and sexual health care after positive diagnosis. We developed this program using the systematic intervention mapping (IM) protocol (six steps). Here, we describe the development process.
Methods Step1 (needs assessment): we conducted a literature review and interviews with 18 MSM and 19 healthcare professionals from public-health and hospital care. Step 2–5: specific objectives were formulated to achieve the program goal and methods were selected to address determinants that needed to be changed. Program production was done with evidence-based methods to overcome barriers identified in the needs assessment. A plan was made for implementation.
Results Step 1 (needs assessment): Healthcare professionals and MSM expressed a positive attitude towards home-based self-sampling. Care providers raised concerns to missing face-to-face counselling and expected that MSM may experience difficulties with blood drawing (finger prick). Steps 2–4: Identified target change behaviors were 1) testing in MSM and 2) adoption of the program in care-providers. Solutions to decrease testing barriers in MSM in the program include: 1) home-based self-sampling 2) reminders (text messaging) 3) social network peer-dissemination of tests and 4) re-testing opportunities. To improve adoption and implementation, a sustainable collaborative infrastructure is set up between public-health service, hospital care providers and general practitioners.
Conclusion The regional homecare program to motivate MSM to HIV/STI testing and to motivate care providers to use it was systematically developed for effective behavioral change. In the program, evidence-based methods to overcome barriers are included to reach an increased number of MSM and motivate care providers. The next step is to pilot implementation of the program.
Disclosure No significant relationships.
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