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Determinants of Repeating an HIV Test Among Gay, Bisexual, and Other Men Who have Sex with Men, and Transgender People Who Use an Online-Requested Self-Sampling Program and Attending Community-Based Testing Venues in Spain (2018–2021)

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Abstract

Our aims were: (1) to characterize gay, bisexual and other men who have sex with men (GBMSM) and transgender (TG) populations using internet-based self-sampling services in the TESTATE project or attending community-based STI/HIV voluntary counselling and testing (CBVCT) services as alternative strategies to formal HIV testing within the Spanish national health system, and (2) to identify factors associated with repeat use of the same screening strategy from November 2018 to December 2021. Demographic, health, and behavioral characteristics of users using complementary strategies were analyzed. We developed a cross-sectional study, with descriptive analysis, HIV cascade, and a multivariate logistic model to identify factors associated with participants’ repeated use of the same screening strategy. We included 9939 users, of whom 94.1% were GBMSM (n = 9348) and 5.9% TG (n = 580), with a high representation of migrants. Reactive results were 3.4% (n = 340), with 3.0% in GBMSM (n = 277/9348) and 10.7% in TG (n = 63/591). 73.8% (n = 251) were confirmed HIV positive and 76.7% (n = 194) were linked to health services. Users repeated the online screening strategy more than CBVCT (44.3% vs. 31.8%), but TG population used face-to-face community services more (8.4% vs. 0.6%). Factors influencing the repetition of the online self-sampling strategy included older age, non-migrant status, and recent HIV testing. In the CBVCT strategy, factors included older age, TG identity, non-migrant status, condom use during the last sexual encounter, and recent HIV testing. In conclusion, both CBVCT and online-requested self-sampling at home are important alternatives to the health system for the provision of HIV testing to GBMSM and TG.

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Acknowledgements

We thank all colleagues from CBVCT centres participating in the COBATEST Network for their continued work in collecting and providing data on HIV testing. The authors would like to thank Gema Ballega, Juan Rus, Marina Herrero, Pili Bonamusa, Llorenç Carrera, and Silvia Gomez for their help in the TESTATE HIV. Harvey Evans for proofreading the manuscript. The authors gratefully acknowledge funding from the COBATEST and TESTATE projects; they had no role in the design of the study, the collection, analysis and interpretation of the data, the writing of the report or the decision to publish it. This work has been carried out within the framework of the Doctorate Programme in Biomedical Research Methodology and Public Health of the Universitat Autònoma de Barcelona.

Funding

This work has been partially supported by the Instituto de Salud Carlos III (Grant number: PI17-00355), ViiV Healthcare, Gilead and the Health Department of the Government of Catalunya.

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Author notes

  1. Héctor Martínez-Riveros and Miguel Alarcón Gutiérrez have contributed equally to this work and share first authorship.

  2. Laura Fernàndez-López and Cristina Agustí have contributed equally to this work and share senior authorship.

Authors and Affiliations

  1. Doctorate Programme in Methodology of Biomedical Research and Public Health, Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

    Héctor Martínez-Riveros & Miguel Alarcón Gutiérrez

  2. Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain

    Héctor Martínez-Riveros, Miguel Alarcón Gutiérrez, Jordi Aceiton Cardona, Marcos Montoro-Fernández, Yesika Díaz, Lucia Alonso, Jordi Casabona, Laura Fernàndez-López & Cristina Agustí

  3. Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain

    Héctor Martínez-Riveros, Miguel Alarcón Gutiérrez, Jordi Aceiton Cardona, Lucia Alonso, Jordi Casabona, Laura Fernàndez-López & Cristina Agustí

  4. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    Yesika Díaz, Cristina Rius Gibert, Jordi Casabona, Laura Fernàndez-López & Cristina Agustí

  5. Epidemiology service, Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain

    Cristina Rius Gibert

  6. Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomédica Sant Pau, Barcelona, Spain

    Cristina Rius Gibert

  7. Department of Paediatrics, Obstetrics and Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Badalona, Spain

    Jordi Casabona

  8. Germans Trias i Pujol Research Institute (IGTP), Edifici Muntanya, Carretera de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Spain

    Héctor Martínez-Riveros

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  1. Héctor Martínez-Riveros
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Contributions

All the signatories participated in the preparation of the article. H Martínez-Riveros and M Alarcon Gutierrez wrote the first version and the final edition, which was reviewed by C. Rius Gibert, C. Agustí, L. Fernandez-Lopez and J. Casabona. M. Montoro-Fernández, J. Aceiton Cardona, Y. Díaz and L. Alonso did the statistical analysis. All signatories have read and approved the final version before it submission for publication.

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Correspondence to Héctor Martínez-Riveros.

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Martínez-Riveros, H., Alarcón Gutiérrez, M., Aceiton Cardona, J. et al. Determinants of Repeating an HIV Test Among Gay, Bisexual, and Other Men Who have Sex with Men, and Transgender People Who Use an Online-Requested Self-Sampling Program and Attending Community-Based Testing Venues in Spain (2018–2021). AIDS Behav (2024). https://doi.org/10.1007/s10461-024-04399-8

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