Research Blog > At-Home HIV Testing and Sexual Risk Taking among MSM
A recent qualitative study conducted with men who have sex with men (MSM) who rarely or never use condoms with multiple partners found that at-home HIV test kits could foster safer sex practices and aid in identifying individuals who are unaware of a positive HIV status. The researchers gave 27 ethnically diverse, HIV negative MSM 16 at-home HIV test kits and a bag of condoms and asked the participants to request each of their sexual partners over a three-month period to submit to an HIV test before engaging in sexual acts.
Over the course of the three months, the study cohort had approximately 140 sexual partners, of which 124 were requested to take the test. Acceptance was high, with 101 acceptances and 23 refusals. Of the 101 sexual partners tested, ten tested HIV positive, six of whom were unaware of their HIV status. A hotline operated by two clinical psychologists was used to help study participants and their partners with complications, questions, and concerns that arose from at-home testing.
According to self-reports, participants tended to like using the at-home kits prior to sexual relations with a partner. They found that refusal was taken as an indicator to not engage in sexual activities or to engage with protection. When the tests yielded positive results, participants did not engage in sexual activity with the partner. Additionally, participants tended to find the 20 minute wait for results was not problematic, with only four participants finding the wait anxiety inducing.
The hotline was used only four times, and all calls were regarding the interpretation of results. No acts of harm were reported on participants or their partners as a result of requests to take the test or as a consequence of receiving a positive result. When using the kits, study participants were three times more likely to report that they reduced unprotected anal sex than they were to report that they were more likely to have unprotected anal sex.
A drawback to this method of curbing sexual risk taking is that the test may not detect those who are HIV positive but still in the window of seroconversion and thus not showing detectable levels of the virus. Additionally, the authors caution that the test may also encourage greater sexual risk taking due to feeling safe, when the partner may not have detectable levels of HIV or may have another STI. The authors also cautioned the generalization of their findings, as their sample was very small, and they were highly selective in choosing participants who were HIV negative, regularly practiced risky sex acts like unprotected anal sex, and understood the existence of a seroconversion phase that may produce false negatives in the test, among other criteria.
Since this article was published in August of 2012, at-home tests have become available to the public. Please visit the IMPACT blog-post about at-home HIV test kits for more information.
Carballo-Diéguez, A., Frasca, T., Balan, I.,Ibitoye, M., & Dolezal, C. (2012). Use of a rapid HIV home test prevents HIV exposure in a high risk sample of men who have sex with men. AIDS and Behavior, 16, 1753-1760.