HIV self-testing for men who have sex with men: an implementation trial in Indonesia

ABSTRACT

We investigated oral fluid testing (OFT) among men who have sex with men (MSM) to increase HIV testing in Bali, Indonesia. We distributed OFT in January–December 2018 to 813 MSM in Bali. Supervised testing was offered first, and unsupervised was only offered to an individual who declined supervised testing. Included participants were MSM who did not have a HIV test result in the last 6 months and declined referral to facility-based testing. Of 813 participants, 93% (765/813) chose supervised testing and 7% (57/813) unsupervised. The OFT result was reactive for 83 (10%), of whom 52/83 (63%) underwent confirmatory testing with 47/52 (90%) found HIV positive. Among confirmed positives, 43/47 (92%) were enrolled in HATI study cohort, of whom 39 (91%) started treatment. At six months follow up, 25/39 (64%) of those initiating treatment were still receiving it, and all had a suppressed viral load. There was an increase in the mean number of MSM tested for HIV by HATI study Bali sites per month, from 100 (95%CI: 85–112) before the intervention to 152 (95% CI: 130–172) during the intervention. Our findings show the potential utility of offering HIV oral fluid self-test kits to scale-up HIV testing in MSM.

Trial registration: ClinicalTrials.gov identifier: NCT03429842.

KEYWORDS:

• HIV
• OFT
• self-testing
• MSM
• Bali

Acknowledgements

We thank the outreach workers at Kerti Praja Foundation (KPF) Clinic and Puskesmas Denpasar Barat III for outreaching the study participants and to the clinical staffs at KPF Clinic for supporting all participants. We thank all HATI research team member for the collaboration during the data collection. We also thank the study participants who gave their time and participation. Finally, we would also like to express our immense gratitude to the late Prof. Wirawan for his guidance, supervision, love, care, and supports during HATI study implementation and during the development of this report.

Disclosure statement

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