AUTHOR=Zhou Yi , Huang Shaoli , Cui Mingting , Guo Zhihui , Tang Haotong , Lyu Hang , Ni Yuxin , Lu Ying , Feng Yunlong , Wang Yuyu , Jing Fengshi , Huang Shanzi , Li Jiarun , Xu Yao , Mei Wenhua 

TITLE=Comparison between HIV self-testing and facility-based HIV testing approach on HIV early detection among men who have sex with men: A cross-sectional study

JOURNAL=Frontiers in Immunology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.857905

DOI=10.3389/fimmu.2022.857905

ISSN=1664-3224

ABSTRACT=Background: To assess whether HIV self-testing (HIVST) had a better performance in identing HIV infected cases than facility-based HIV testing (HIVFBT) approach.
Methods: A cross-sectional study was conducted among men who have sex with men (MSM) by using online questionnaire (including information on sociodemographic, sexual biography and HIV testing history) and blood samples (for limiting antigen avidity enzyme immunoassay, gene subtype testing and take confirmed HIV testing). MSM who are living with HIV who were identified through HIVST and HIVFBT were compared. Chi-square or Fishers’ Exact tests were used to explore any association between both groups and their subgroups.
Results: In total, 124 MSM HIV cases were identified from 2017 to 2021 in Zhuhai, China, including 60 identified through HIVST and 64 through HIVFBT.  People living with HIV in the HIVST group was younger (≤30 years: 76.7% vs 46.9%) and better educated (>High school: 61.7% vs 39.1%), but had higher viral load (≥1000 copies/ml: 71.7% vs 50.0%) than MSM cases identified through HIVFBT. The proportion of early HIV infection in the HIVST group were higher than the HIVFBT group, using four Recent Infection Testing Algorithms (RITAs) (RITA 1: 46.7% vs 25.0%; RITA 2: 43.3% vs 20.3%; RITA 3: 30.0% vs 14.1%; RITA 4: 26.7% vs 10.9%. All p<0.05).
Conclusions: The study showed that HIVST had relatively better HIV early detection among MSM, and recent HIV infection cases mainly appeared on younger and better educated MSM. Comparison of facility-based HIV testing, the HIV self-testing is easier to reach the most risk population on time, and tend to identify the case early. Further implementation studies are needed to fill the knowledge gap on this medical service model among MSM and other target populations.