Bangkok Online Testing on MSM



 DESCRIPTION (provided by applicant): The HIV epidemic is accelerating among young men who have sex with men (YMSM, 18 to 24 years) in Bangkok where HIV incidence was reported to be 8.8 to 12.2 per 100 person-years, the highest such incidence documented in Asia. Engagement and retention of YMSM of unknown or HIV negative serostatus in regular (at least annual) HIV testing is essential 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 antiretrovial treatment and care to improve disease outlook and prevent onward HIV transmission. However, structural, logistical and psychosocial barriers limit the uptake and retention of Thai 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 qualitatively explore barriers and facilitators to OHT among Bangkok YMSM; 2) To quantitatively examine current perceptions, barriers, facilitators to HIV testing among Bangkok YMSM and estimate the proportion likely to undergo OHT, identify factors associated with willingness to access OHT and to participate in a pilot study of this new HIV testing modality; and 3) To determine the acceptability and feasibility of OHT using a new HIV rapid diagnostic antibody/antigen-based self-test in real time and a self-collected dried blood spot (DBS) 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 6-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 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 Thai YMSM.