HIV self-testing with online supervision for Vietnamese MSM

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PROJECT SUMMARY/ABSTRACT There is a concentrated HIV epidemic among young men who have sex with men in Vietnam where HIV incidence was reported to be 5.8 per 100 person-years, one of the highest incidences in the region. Regular (at least annual) HIV testing of YMSM of unknown or HIV negative serostatus is critical for timely linkage to HIV prevention services, such as risk reduction counseling and HIV chemoprophylaxis. Among YMSM unaware of an existing or new HIV infection, timely identification is necessary to increase linkage and initiation of antiretroviral treatment and care to improve disease outlook and prevent onward HIV transmission. However, structural, logistical and psychosocial barriers limit the uptake and retention of Vietnamese MSM in regular HIV testing, hindering the rollout of much needed HIV prevention and treatment services targeting this population. This study proposes the use of online HIV testing (OHT) as an alternative HIV testing modality to increase engagement, retention and linkage of YMSM in HIV prevention, treatment and care services. The specific aims of this research proposal are 1) To identify potential barriers and facilitators to uptake of OHT among YMSM; 2) to develop an empirical profile of barriers and facilitators to HIV testing among YMSM, including an estimate of the proportion of YMSM likely to participate in an OHT intervention; and 3) To conduct a preliminary assessment of the OHT intervention, including introduction of a new HIV rapid diagnostic antibody/antigen-based self-testing with an HIV counselor through video conferencing, and “real time” self-collected dried blood spot (DBS) technology with centralized HIV DNA testing. Results of rapid testing will be read- and of centralized testing will be delivered by video conference, followed by discussion, post-test counseling and linkage to care and treatment, in a 12-month pilot study. Particularly, logistical issues, concerns over rapid HIV self-testing, DBS self-collection and laboratory testing, reading or reporting of results by video conferencing will be assessed, as well as how OHT may help to overcome some of the existing barriers to venue-based HIV testing. Using new HIV diagnostic and online technologies, OHT may be a promising strategy to increase engagement, retention and linkage to HIV prevention, treatment and care services among Vietnamese YMSM.