In Thailand, HIV testing uptake is suboptimal in the key population groups of gay men and other men who have sex with men, and transgender women. In response to this challenge, HIV self-testing (HIVST) was implemented through a study comparing the uptake of HIVST with referral to standard HIV testing services.
Mobilization took place through existing physical and virtual outreach activities run by community-based organisations (CBOs). Members of the two target key population groups were given a brief explanation of the study and offered the options of assisted HIVST, unassisted HIVST, or referral to a facility for blood-based HIV testing (standard of care).
Those opting for unassisted testing could obtain the HIVST kits through community distribution by a peer lay provider, at CBO facilities or via an express mail service, according to their preference. These kits contained detailed instructions for test taking and results interpretation, trained lay provider contact details (for further support if needed), details of health facilities that offered confirmatory HIV testing and a unique identifier code to access secure pages on the Thai-language study website with a step by-step video on HIVST, an online questionnaire, and a place to report test results.
Those opting for assisted HIVST were able to conduct testing at their choice of private venue, where a trained peer lay provider supported with verbal instructions before and during the testing procedure and was also able to assist with conducting the test or interpreting the result if requested.
Impact: A total of 1,966 (78.5%) of participants were enrolled through face-to-face contact, while 538 (21,5%) were enrolled through social media, with nearly one third (36.1%) being first-time testers. Almost all (99.3%) participants opted for HIVST rather than referral for the facility-based standard of care and a large majority (84.3%) opted for assisted HIVST over unassisted HIVST. While 179 participants required confirmatory testing, only 60.3% of these accessed these services at study sites.
Information on the study and HIVST
Offer of assisted / unassisted HIVST or referral to facility-based services
During virtual and in person CBO outreach activities
Online (social media)
Assisted HIVST: Verbal instruction and option of additional assistance for testing and interpretation
Unassisted HIVST: HIVST using kit with written instructions, online resources and linkage materials
At client’s convenience
Assisted HIVST: In client selected private community site
Unassisted HIVST: HIVST distribution via express mail, collection from CBO or delivery by peer lay provider; HIVST administration at client chosen venue
Assisted HIVST: Peer lay provider
Unassisted HIVST: Client
Telephonic follow-up and referral to confirmatory testing or HIV prevention services
Within 48 hours after assisted or unassisted HIVST
Social media messaging apps