Background: The UK needs a dramatic increase in HIV testing to reduce undiagnosed HIV and late diagnoses. HIV self-testing offers the potential to significantly increase the number and frequency of tests.
Methods: : We piloted a national HIV self-testing service, which was delivered online to men who have sex with men (MSM) and Black Africans living in the UK. A dedicated website was created and the service was promoted through social media. Participants provided demographic information, contact details and answers to HIV risk assessment questions. An HIV self-testing kit was then posted to them. Service users were asked to log onto a secure page on the website to inform us of their result. Anyone with a reactive result was called for support or advice and to ensure access to care for confirmatory testing. An online satisfaction survey was sent to everyone who gave consent.
Results: The pilot ran from 24th June - 5th Aug 2016. A total of 4,879 kits were ordered. 3,021 people (62%) informed us of their result. 19% had never had an HIV test before and a further 37% had last tested >1 year ago. 68% reported condomless anal sex in the previous 3 months with 28% reporting this with 2 or more partners. 28 people (0.92%) reported a reactive result. 3 (10.7%) people already knew they were HIV positive and one result was confirmed as a false positive. Of the remaining 24 all were MSM. 15/24 (62.5%) identified as white British. Contact was made with 22 (92%) all of whom had accessed confirmatory testing and HIV services. 602 people responded to the survey. 98% would use the service again, 91% felt self testing encouraged them to test and 91% were happy with the support they received.
Conclusions: We have demonstrated the feasibility and acceptability of HIV self-testing in the UK. It also demonstrated a high percentage were willing to report their results which allowed for confirmation of linkage to care. We believe that an investment in HIV self-testing will compliment existing options and provide a cost-effective way to scale up our approach to testing.