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Web-based HIV self-test distribution encourages testing and linkage among young men who have sex with men and first-time testers in three provinces in Viet Nam

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BACKGROUND: Approximately 15% of people living with HIV, primarily key populations, do not know their HIV status in Viet Nam. Web-based HIV self-test (HIVST) distribution was piloted to increase access to HIV testing, PrEP and ART, especially in the context of Covid-19.
DESCRIPTION: Web-based HIVST distribution started in Can Tho province (Nov 2020) and then Nghe An and Hanoi (mid-April 2021). Clients are encouraged to create a website account to request HIVST, together with condoms, lubricants or needles and syringes. Clients choose how test kits and other commodities, are delivered (courier/peer educator) or opt for self-pick-up. Reporting of self-test result is encouraged, but not required. Following distribution, staff or peers support clients to access further testing, PrEP or ART. User demographic information and risk behaviors were collected at account registration and via voluntary client-satisfaction survey. Data were automatically stored and compiled in the web-system. Linkage was documented by staff and peers in the same system.
LESSONS LEARNED: As of 5th May 2021, 1269 individuals completed initial self-risk assessment via the website and 1188 opened an account and requested HIVST. Among these clients, 82.3% were male, 54.5% were '¤25-years, 67.1% were MSM, 67.6% had '¥2 sexual partners, 22.3% had an STI, 10.1% shared needles, 46.8% were first-time testers and 17.4% tested >12-months ago. 1077 received HIVST, 851 (79.0%) reported their result and 29/851 (3.4%) were reactive. 22/29 (72.4%) received confirmatory test. 21/22 were HIV-positive, and 21/21 received ART. Of the 823 reporting HIV-negative results, 124 (15.1%) enrolled in PrEP. 670/1077 (62%) of self-testers completed the satisfaction survey; of which, 81.9% were 'very satisfied', 98.8% indicated the website was easy to access, 93.6% reported HIVST was easy, and 98.9% were willing to introduce to others.
CONCLUSIONS: Web-based HIVST was well accepted to many young key populations especially MSM and first time-testers and provides an additional way to increase access to testing, prevention and treatment; especially in context of COVID-19 restrictions. The pilot will be continued in these three provinces to inform national scale-up.