Background: HIV in Viet Nam is concentrated in key populations (KP), including people who inject drugs (PWID), men who have sex with men (MSM), sex workers (SWs) and their partners. Despite KP being disproportionately affected, uptake of HIV testing services remains low. To address this gap, community-led HIV self-testing (HIVST) was introduced and evaluated.
Methods: Between January and November 2018, KP and their partners were offered HIVST by peer-educators at drop-in houses or coffee shops in Thai Nguyen and Can Tho provinces. Self-testers were given the choice to test with or without assistance. Community-led outreach and social networks (MSM dating apps, Facebook, Zalo) were used to promote HIVST and follow-up with self-testers. During distribution, peer educators collected client demographics and self-reported risk behaviour. Peer educators contacted all those taking a kit; recording client-reported self-test results and linkage-to-care.
Results: 50% (2009/4014) opted for HIVST; 80.5% (1618/2009) were first-time testers, 5.1% (103/2009) was confirmed HIV positive and 98.1% (101/103) initiated ART. MSM (76.0%, 1526/2009) and young KP (aged ≤25) (69.4%, 1394/2009) accounted for greatest proportion of self-testers, compared with other KP and older groups (Table 1).
Given the choice, KP and partners chose assisted (66.0%, 1325/2009) over unassisted HIVST (34.0%, 684/2009, P< 0.001). Those selecting unassisted HIVST were more likely to be female (17% vs 8.1%, P< 0.001); < 25 years (87.4% vs 60.1%; P< 0.001); MSM (82.0% vs 72.8%, P< 0.01); or partner of HIV-positive self-testers and KP (6.3% vs 3.5%, P< 0.001) [table_1].
Conclusions: Community-led HIVST with and without assistance successfully reached KP and their partners; including those never tested and undiagnosedHIV. Offering HIVST with different support may increase testing uptake among KP and their partners. Unassisted HIVST may be particularly beneficial for reaching young KP especially MSM, and partners of HIV-positive self-testers and KP.