A successful launch of the first HIV self-testing pharmacy-based service demonstration project, Bangkok, Thailand

BACKGROUND: The Thai Ministry of Public Health (MoPH) considers HIV self-testing (HIVST) a complementary approach to increase access to and uptake of HIV testing especially among men who have sex with men (MSM) and Transgender women(TGW), who historically have low access to HIV testing. We present results of the first HIVST pharmacy-delivered model to assess the acceptance of unassisted HIVST among these populations in Bangkok.
METHODS: Oral HIVST kits were available through 36 retail Boots pharmacies located in Bangkok. Participants who were directed to the project website during August and December 2020 and who met the inclusion criteria (i.e., Thai MSM/TGW '¥ 18 years of age, who lived/worked in Bangkok, had a smart phone with internet connection, and had never been diagnosed with HIV) were invited to register online. All eligible participants provided written informed consent online, completed baseline and follow-up questionnaires, picked up the free HIV test (OraQuick®) at the pharmacy, and performed the test unassisted. Participants testing HIV positive were encouraged to confirm test results at designated health facilities. Hotline was provided for additional counseling if needed. Questionnaire data including demographics, behavioral and HIV treatment information were collected electronically.
RESULTS: Of 1,511 MSM/TGW who consented, 826(55%%) were eligible. Of these, 776(94%) were MSM, 239(31%) were 18-25 years old, 576(70%) completed >bachelor's degree, 653(79%) were employed, over 70% had self-perceived HIV risk, and 343(42%) had never tested for HIV. As of January 2021, 440(53%) picked up the test kit at the pharmacy, 274(62%) performed the test. Of these, 15(5%) reported reactive test results and 205(75%) reported that the test kit was easy to use. Few (n=41) participants called the hotline for additional counseling.
CONCLUSIONS: This is the first project in Thailand that demonstrates the use of unassisted HIVST delivered via pharmacies. Based on our findings, HIVST is an effective way to reach MSM/TGW who have never tested for HIV. Those who reported use of HIVST kits expressed high acceptability, suggesting HIVST as an acceptable and complementary strategy to HIV case finding strategy for these populations. More in-depth analysis on linking HIV-positive clients to confirmatory testing is underway.