There has recently been a move towards online provision of HIV self-testing and self-sampling for people to test themselves. Our local activation partners, the GMI Partnership, comprised of Positive East, METRO and Spectra have been looking at how self-testing and self-sampling can be incorporated into current and future community-based HIV testing and outreach services.

There are questions about how community-based organisations can incorporate self-testing and self-sampling in their work, in order to increase access to testing for those who need it.

The GMI Partnership is a consortium of three community-based agencies (Positive East, METRO and Spectra) who provide sexual health promotion and HIV prevention services across London. In collaboration with Freedoms, the GMI Partnership deliver condom distribution and an outreach service for men who have sex with men (MSM) funded by the pan-London HIV prevention programme, as part of the Do It London campaign. Dee Wang, Research and Performance Manager at Spectra, tells us about how they are addressing self-testing and self-sampling.

‘Conducting extensive surveys via Grindr and through our face-to-face work in high-risk venues, we asked high-risk MSM about self-testing and self-sampling in a community-based setting,’ she said. ‘What we found was that community-based testing and outreach complements self-testing and self-sampling.’

Of the 2,889 MSM who undertook their survey over Grindr:

• Only 22% understood the difference between self-testing and self-sampling.
• Of those who did understand the difference, 30% still preferred to be tested by a professional.
• Of the 2,889 men, 33% would prefer to be coached on how to self-test or self-sample before doing it themselves.

‘This data indicates that there is still work to be done around informing the community on the differences between self-testing and self-sampling (especially as this was a relatively HIV literate group, with 73% and 71% having heard of PEP and PrEP respectively),’ Dee said. ‘Secondly, it shows that there will always be a group of men who prefer to be tested by a professional.’

‘The finding which also stood out was that 33% of the MSM surveyed would prefer to be coached in the use of self-tests/ self-sampling tests before doing it themselves,’ said Dee. ‘These findings led us to develop the GMI community coaching model.’

GMI community coaching model

The GMI Partnership now provides community coaching with HIV testing. ‘We coach individuals on how to use both self-testing kits, and self-sampling kits. If desired, we then use the self-test kit as a point-of-care test (POCT),’ explains Norman Gillard, one of the GMI Partnership Outreach Coordinators from the METRO Charity.

Of the 159 men who GMI have so far provided with community coaching:

• 96% agreed that they were able to better understand how self-testing for HIV works after being coached.
• 80% felt more confident with the GMI worker supporting while doing a self-test.
• 69% believed that they would be more comfortable to test themselves next time.

‘The GMI Partnership has always recognised that for many individuals, community-based services are the first step in a health care journey from an outreach venue into a clinic. The same may be true with self-testing and self-sampling. With the coaching model, 69% of individuals felt more comfortable with testing themselves in the future,’ Norman pointed out.

‘Still, we need to recognise that there will always be those who need to test but who would rather access services in their own community settings’.