Study Evaluating Self-Collected Specimen Return for HIV, Bacterial STI, and Potential Pre-Exposure Prophylaxis Adherence Testing Among Sexual Minority Men in the United States. Issue 4 (August 2022)

• Record Type: Journal Article
• Authors: Sharma, Akshay; Gandhi, Monica; Sallabank, Gregory; Merrill, Leland; Stephenson, Rob
• Is Part Of: American journal of men's health. Volume 16:Issue 4(2022)
• Publication Date: 2022-08
• Subjects: HIV -- sexually transmitted diseases -- pre-exposure prophylaxis -- self-testing -- sexual and gender minorities; Men -- Diseases -- Periodicals; Sex factors in disease -- Periodicals; Men -- Health and hygiene -- Periodicals; Men -- Health and hygiene -- United States -- Periodicals; Men -- Medical care -- Periodicals; 362.10811
• DOI: 10.1177/15579883221115591
• Languages: English
• ISSNs: 1557-9883

Abstract

Web-based HIV and sexually transmitted infection (STI) prevention studies are increasingly requesting gay, bisexual, and other men who have sex with men (GBMSM) to return self-collected specimens for laboratory processing. Some studies have solicited self-collected extragenital swabs for gonorrhea and chlamydia testing, but to date, none have solicited self-collected hair samples for pre-exposure prophylaxis (PrEP) adherence testing. Project Caboodle! offered 100 racially/ethnically diverse GBMSM aged 18 to 34 years residing across the United States a choice to self-collect at home and return by mail any of the following: a finger-stick blood sample (for HIV testing), a pharyngeal swab, a rectal swab and a urine specimen (for gonorrhea and chlamydia testing), and a hair sample (to visually assess its adequacy for PrEP drug level testing). Despite not incentivizing specimen return, 51% mailed back at least one type of specimen within 6 weeks (1% returned three specimens, 11% returned four specimens and 39% returned all five specimens). The majority of returned specimens were adequate for laboratory processing. Significantly more participants without a college education ( p = .0003) and those who were working full-time or part-time ( p = .0070) did not return any specimens. In addition, lower levels of HIV-related knowledge ( p = .0390), STI-related knowledge ( p = .0162), concern about contracting HIV ( p = .0484), and concern about contracting STIs ( p = .0108) were observed among participants who did not return any specimens. Self-collection of specimens holds promise as a remote monitoring strategy that could supplement testing in clinical settings, but a better understanding of why some GBMSM may choose to fully, partially, or not engage in this approach is warranted.