Usage of self-tests for HIV and STI in the general population versus sexual risk groups
F. Zuure1, U. Davidovich1, H. Fennema1, M. Prins1,2
1Public Health Service of Amsterdam, Research, Infectious Diseases, Amsterdam, Netherlands, 2, Academic Medical Center (University of Amsterdam), Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Amsterdam, Netherlands
Background: Self-tests are commercial tests done autonomously by the tested person without involving a medical doctor or certified laboratory. We assessed HIV/STI self-test use among three populations in Amsterdam.
Methods: Data regarding demographics, sexual behaviour, and HIV/STI self-test use were collected between 2007-2008 in a representative population-based health study among 2,687 inhabitants of Amsterdam aged 16-54 years; among 419 homosexual men from the Amsterdam Cohort Studies (median age=35 years, IQR=31-40 years); and in an anonymous bi-annual HIV-survey among 1,995 STI-clinic visitors (median age=27 years, IQR=23-35 years).
Results: In the past 12 months, 0.8% (95%CI:0.5-1.3%) of the Amsterdam population aged 16-54 years used self-tests for HIV/STI of which 30% (95%CI:24-38%) for HIV. In univariate analyses, HIV self-test use was higher among men (0.4%; women: 0%, p< 0.01), low educated individuals (0.6%; highly educated: 0.1%, p=0.03), homosexual men (1.0%; heterosexual men: 0.4%; women: 0%, p< 0.01), individuals reporting >9 sexual partners (1.9%; 2-9 partners: 1.2%; 1 partner: 0%, p< 0.01), and among Surinamese and other non-Western individuals (0.6%, 1%; Dutch: 0.1%, p=0.09).
In the study among homosexual men, 0.2% (1/419) ever used a self-test for syphilis, and 1.7% (7/419) for HIV (no statistics were performed due to small numbers).
Of the STI-clinic visitors, 2.1% (41/1,995) used self-tests for HIV/STI in the past 6 months. In univariate analyses, older age, homosexual orientation, and having had sex with a HIV-infected partner were significantly associated with HIV/STI self-test use. In multivariate analyses, only age remained significantly associated: those >34 years were more likely to self-test compared to those < 22 years (OR=4.7, 95%CI:1.4-15.9).
Conclusions: Self-test use in the general population is low, but seems higher in groups at increased risk for HIV/STI. Professional health care providers need to monitor these trends as self-test usage might become more popular, and should consider the development of supportive interventions.
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