Barriers and strategies to enhance uptake of HIV self-testing among men who have sex with Men: A restricted review

Document Type : Review Article

Authors

1 Department of HIV and Infectious Diseases, Jhpiego, an affiliate of John Hopkins University, Abuja, Nigeria

2 JSI Research and Training Institute Inc. (JSI), Abuja, Nigeria

3 Department of Public Health, Daffodil International University, Dhaka 1216, Bangladesh

4 Department of Public and Community Health, Faculty of Medicine and Health Sciences, Frontier University Garowe, Puntland, Somalia

5 Department of Media Studies and Journalism, University of Liberal Arts Bangladesh (ULAB), Mohammadpur, Dhaka, Bangladesh

6 Department of Pharmacy, Bangladesh University, Dhaka

Abstract

Background:  This restricted review examines the barriers and facilitators to HIV self-testing (HIVST) among men who have sex with men (MSM), a key population significantly affected by HIV/AIDS. Despite advancements in HIV testing methods, MSM continues to face unique challenges due to stigma, discrimination, and criminalization, which hinder their access to conventional HIV testing services. This review aims to identify strategies to increase the uptake of HIVST among MSM and provide actionable recommendations based on these findings. Methods: We conducted a systematic search adhering to PRISMA guidelines, including databases like PubMed, DOAJ, CrossRef, Cochrane Library, and Google Scholar. The review includes qualitative, quantitative, and mixed-method research published between 2013 and 2022. Results: Our study identified barriers such as age, education level, and socio-economic status to HIV self-testing (HIVST) uptake. Among Chinese MSM populations, 38.2% to 40.4% have utilized HIVST, with 92% expressing willingness to use it in the future. MSM who use HIVST kits demonstrate higher testing frequencies. Moreover, facilitators include perceived high-risk behaviour, internet access, and confidentiality. Additionally, effective strategies to enhance uptake include peer distribution, incentivization, mobile health interventions, and subsidized or free distribution of kits. Conclusion: The review underscores the importance of HIVST in increasing access to HIV testing among MSM, a critical step towards achieving the UNAIDS 95:95:95 goal. It highlights the need for innovative, tailored approaches to address MSM's unique challenges. The insights gained from this review are vital for informing public health policies, enhancing screening and prevention programs, and improving HIVST accessibility for MSM

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