Increases in HIV status disclosure and sexual communication between South African men who have sex with men and their partners following use of HIV self-testing kits

ABSTRACT

Availability of HIV self-testing may increase HIV testing frequency among men who have sex with men (MSM). It is unclear, however, if self-testing may impact HIV-related sexual behaviors among MSM, including HIV status disclosure and condom use. We conducted a mixed methods analysis of changes in HIV-related behaviors after HIV self-testing introduction, using data from 110 MSM participating in a feasibility and acceptability study of HIV self-testing in Mpumalanga Province, South Africa. We found increased HIV status disclosure from study participants to sexual partners after HIV self-testing introduction, from 61.8% at baseline to 75.5% at 6-month follow-up (p = 0.04), but decreased condom use with female partners (p = 0.03). Qualitative interviews reveal that some participants used test results to inform condom use. Distribution of self-testing kits can improve mutual disclosure, but should be accompanied by information stressing that the tests may not detect early HIV infections or other sexually transmitted infections.

KEYWORDS:

• HIV self-testing
• condom use
• HIV status disclosure
• men who have sex with men (MSM)
• South Africa

Acknowledgments

We thank the study teams: Fikile Cibi, and Nokuthula Boyisi in Gert Sibande; Bongani Mabasa and Simphiwe Thabede in Ehlanzeni; and Angel Thomo who worked at both sites. We thank Helen Struthers, Helen Savva, Emily Agnew, Alex Marr, and Tom Osmand for supporting the study. We thank Adrian Puren and Beverly Singh at NICD for test validation and controls provision.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Centers for Disease Control and Prevention [grant number U2GHH000251]; National Institutes of Health [grant number R21MH103038].