What would you choose: Online or Offline or Mixed services? Feasibility of online HIV counselling and testing among Thai men who have sex with men and transgender women and factors associated with service uptake

Nittaya Phanuphak, Tarandeep Anand, Jureeporn Jantarapakde, Chattiya Nitpolprasert, Kanittha Himmad, Thanthip Sungsing, Deondara Trachunthong, Sangusa Phomthong, Petchfa Phoseeta, Sumitr Tongmuang, Pravit Mingkwanrungruang, Dusita Meekrua, Supachai Sukthongsa, Somporn Hongwiangchan, Nutchanin Upanun, Jiranuwat Barisri, Tippawan Pankam, Praphan Phanuphak, Nittaya Phanuphak, Tarandeep Anand, Jureeporn Jantarapakde, Chattiya Nitpolprasert, Kanittha Himmad, Thanthip Sungsing, Deondara Trachunthong, Sangusa Phomthong, Petchfa Phoseeta, Sumitr Tongmuang, Pravit Mingkwanrungruang, Dusita Meekrua, Supachai Sukthongsa, Somporn Hongwiangchan, Nutchanin Upanun, Jiranuwat Barisri, Tippawan Pankam, Praphan Phanuphak

Abstract

Introduction: HIV testing coverage remains low among men who have sex with men (MSM) and transgender women (TGW). We studied characteristics of Thai MSM and TGW who chose online and/or offline platforms for HIV counselling and testing and the feasibility of integrating online technologies and HIV self-testing to create service options.

Methods: From December 2015 to June 2017, MSM and TGW enrolled from Bangkok Metropolitan Region and Pattaya could choose between: offline HIV counselling and testing (Offline group), online pre-test counselling and offline HIV testing (Mixed group), and online counselling and online, supervised, HIV self-testing (Online group). Sociodemographic data, risk behaviour and social network use characteristics were collected by self-administered questionnaires. Logistic regression models identified covariates for service preferences.

Results: Of 472 MSM and 99 TGW enrolled, 202 self-selected the Offline group, 158 preferred the Mixed group, and 211 chose the Online group. The Online group had the highest proportion of first-time testers (47.3% vs. 42.4% vs. 18.1%, p < 0.001) and reported highest HIV prevalence (15.9% vs. 13.0% vs. 3.4%, p = 0.001) as compared to Offline and Mixed groups, respectively. Having tested for HIV twice or more (OR 2.57, 95% CI 1.03 to 6.41, p = 0.04) increased the likelihood to choose online pre-test counselling. Being TGW (OR 6.66, 95% CI 2.91 to 15.25, p < 0.001) and using social media from four to eight hours (OR 2.82, 95% CI 1.48 to 5.37, p = 0.002) or >8 hours (OR 2.33, 95% CI 1.05 to 5.16, p = 0.04) increased selection of online, supervised, HIV self-testing. Providers primarily used smartphones (79.2%) and laptops (37.5%) to deliver online services. Self-testing strip image sharpness and colour quality were rated "good" to "excellent" by all providers. Most participants (95.1%) agreed that online supervision and HIV self-testing guidance offered were satisfactory and well delivered.

Conclusions: Online HIV services among MSM and TGW are feasible in Thailand and have the potential to engage high proportions of first-time testers and those with high HIV prevalence. When designing public health interventions, integrating varied levels of online HIV services are vital to engage specific sections of MSM and TGW populations in HIV services.

Clinical trial number: NCT03203265.

Keywords: HIV testing; Online; counselling; men who have sex with men; transgender women.

© 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Figures

Figure 1
Figure 1
Flow of recruitment and enrolment of men who have sex with men (MSM) and transgender women (TGW) participants.

References

    1. Joint United Nations Programme on HIV/AIDS (UNAIDS). Prevention gap report. Switzerland: UNAIDS; 2016. 2016. [cited 2017 November 17]. Available from:
    1. Thailand Working Group on HIV/AIDS Projection . AIDS Epidemic Model Projection for HIV/AIDS in Thailand 2010‐2030. Thailand: 2010.
    1. National AIDS Committee . Thailand AIDS Response Progress Report 2015 Thailand. 2015. [cited 2017 November 17]. Available from: .
    1. Rainbow Sky Association of Thailand . Outreach activity database under the Global Fund to Fight AIDS, Tuberculosis and Malaria. June 2010‐ May 2011. Thailand: Rainbow Sky Association of Thailand; 2011.
    1. Vannakit R, Jantarapakde J, Pengnonyang S, Pankam T, Trachunthong D, Pussadee K, et al. High linkage to ART and HIV RNA suppression among HIV‐positive MSM and TG, along with high PrEP uptake among HIV‐negative MSM and TG, through community‐led health service model in Thailand, abstract TUPED1313. 9th IAS Conference on HIV Science; 2017 July 23‐26; Paris, France.
    1. Department of Disease Control, Thai Ministry of Public Health . Routinely integrated HIV information system database. January – December 2017. Thailand: Department of Disease Control, Thai Ministry of Public Health; 2017.
    1. Flowers P, Estcourt C, Sonnenberg P, Burns F. HIV testing intervention development among men who have sex with men in the developed world. Sex Health. 2017;14(1):80–8.
    1. Sharma A, Stephenson RB, White D, Sullivan PS. Acceptability and intended usage preferences for six HIV testing options among internet‐using men who have sex with men. Springerplus. 2014;3:109.
    1. Anand T, Nitpolprasert C, Phanuphak N. Online‐to‐offline models in HIV service delivery. Curr Opin HIV AIDS. 2017;12(5):447–57.
    1. Pant Pai N, Sharma J, Shivkumar S, Pillay S, Vadnais C, Joseph L, et al. Supervised and unsupervised self‐testing for HIV in high‐ and low‐risk populations: a systematic review. PLoS Med. 2013;10(4):e1001414.
    1. LeGrand S, Muessig KE, Horvath KJ, Rosengren AL, Hightow‐Weidman LB. Using technology to support HIV self‐testing among MSM. Curr Opin HIV AIDS. 2017;12(5):425–31.
    1. Anand T, Nitpolprasert C, Trachunthong D, Kerr SJ, Janyam S, Linjongrat D, et al. A novel Online‐to‐Offline (O2O) model for pre‐exposure prophylaxis and HIV testing scale up. J Int AIDS Soc. 2017;20(1):21326.
    1. Anand T, Nitpolprasert C, Ananworanich J, Pakam C, Nonenoy S, Jantarapakde J, et al. Innovative strategies using communications technologies to engage gay men and other men who have sex with men into early HIV testing and treatment in Thailand. J Virus Erad. 2015;1(2):111–5.
    1. Anand T, Nitpolprasert C, Kerr S, Apornpong T, Ananworanich J, Phanuphak P, et al. Factors influencing and associated with the decision to join in Thailand's first online supervised HIV self‐testing and counselling initiative. J Int AIDS Soc. 2016;19(8 Suppl 7):21487.
    1. Department of Disease Control, Thai Ministry of Public Health . Thailand National Guidelines on HIV/AIDS Treatment and Prevention 2014. Thailand: 2014.
    1. Adam's Love . Adam's Love HIV Self‐Testing Video. Thailand: Adam's Love; 2016. [cited 2018 May 4]. Available from: .
    1. Anand T, Nitpolprasert C, Kerr SJ, Apornpong T, Ananworanich J, Phanuphak P, et al. Implementation of an online HIV prevention and treatment cascade in Thai men who have sex with men and transgender women using Adam's Love Electronic Health Record system. J Virus Erad. 2017;3(1):15–23.
    1. Yan H, Yang H, Raymond HF, Li J, Shi LE, Huan X, et al. Experiences and correlates of HIV self‐testing among men who have sex with men in Jiangsu province. China. AIDS Behav. 2015;19(3):485–91.
    1. World Health Organization (WHO). Guidance on provider‐initiated HIV testing and counselling in health facilities Switzerland: WHO; 2007. [cited 2017 November 17]. Available from: .
    1. Muessig KE, Bien CH, Wei C, Lo EJ, Yang M, Tucker JD, et al. A mixed‐methods study on the acceptability of using eHealth for HIV prevention and sexual health care among men who have sex with men in China. J Med Internet Res. 2015;17(4):e100.
    1. Chiu CJ, Young SD. Correlates of requesting home HIV self‐testing kits on online social networks among African‐American and Latino men who have sex with men. AIDS Care. 2016;28(3):289–93.
    1. Cipolletta S, Votadoro R, Faccio E. Online support for transgender people: an analysis of forums and social networks. Health Soc Care Community. 2017;25(5):1542–51.
    1. Patel VV, Masyukova M, Sutton D, Horvath KJ. Social media use and HIV‐related risk behaviors in young black and Latino gay and bi men and transgender individuals in New York City: implications for online interventions. J Urban Health. 2016;93(2):388–99.
    1. Anand T, Nitpolprasert C, Kerr SJ, Nakpor T, Champa W, Linjongrat D, et al. HIV risks among Thai transgender women and potential technology‐based HIV prevention interventions, abstract MOPE0671. 9th IAS Conference on HIV Science; 2017 July 23–26; Paris, France.
    1. Makusha T, Knight L, Taegtmeyer M, Tulloch O, Davids A, Lim J, et al. HIV self‐testing could “revolutionize testing in South Africa, but it has got to be done properly”: perceptions of key stakeholders. PLoS ONE. 2015;10(3):e0122783.
    1. Joint United Nations Programme on HIV/AIDS (UNAIDS). A short technical update on self‐testing for HIV Switzerland: UNAIDS; 2014. [cited 2017 November 17]. Available from: .
    1. Livant E, Heaps A, Kelly C, Maharaj R, Samsunder N, Nhlangulela L, et al. The fourth generation AlereTM HIV Combo rapid test improves detection of acute infection in MTN‐003 (VOICE) sample. J Clin Virol. 2017;94:15–21.
    1. Unitaid . HIV rapid diagnostic tests for self‐teting, 3rd edition Switzerland: Unitaid; 2017. [cited 2017 November 17]. Available from: .
    1. Olok GT, Yagos WO, Ovuga E. Knowledge and attitudes of doctors towards e‐health use in healthcare delivery in government and private hospitals in Northern Uganda: a cross‐sectional study. BMC Med Inform Decis Mak. 2015;15:87.
    1. Fujino Y, Kawamoto R. Effect of information and communication technology on nursing performance. Comput Inform Nurs. 2013;31(5):244–50.
    1. Latulippe K, Hamel C, Giroux D. Social health inequalities and eHealth: a literature review with qualitative synthesis of theoretical and empirical studies. J Med Internet Res. 2017;19(4):e136.
    1. Guadamuz TE, Cheung DH, Wei C, Koe S, Lim SH. Young, online and in the dark: scaling Up HIV testing among MSM in ASEAN. PLoS One. 2015;10(5):e0126658.

Source: PubMed

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