Preferences and Acceptability of Testing for Sexually Transmitted Infections in an HIV Pre-Exposure Prophylaxis clinic in Hanoi, Vietnam.

Abstract

Background: Men who have sex with men (MSM) using HIV Pre-Exposure Prophylaxis (PrEP) are a vulnerable population with a high prevalence of sexually transmitted infections (STIs). Self-collection of specimens could improve STI testing, yet implementation in low-resource settings is limited. The study aimed to assess the feasibility and acceptability of self-collection for STI testing and to understand STI testing preferences among PrEP clients in Hanoi, Vietnam.

Methods: From January to December 2022 MSM aged 16 and older, participating in a clinic-based HIV PrEP program were enrolled. Participants self-collected pharyngeal, anal, and urine samples for Chlamydia trachomatis and Neisseria gonorrhoeae testing. Testing preferences were assessed through conjoint analysis using eight hypothetical testing profiles across five testing attributes; each profile was rated on a Likert scale (0-5) to create an impact score. Differences between attributes were assessed using a two-sided, one-sample t-test of the impact score.

Results: There were 529 participants enrolled; all were male. Specimens from three sites were provided by 97.9% (518/529). Mean satisfaction with self-collection was 4.3 (SD: 1.0), 99.4% reported they would perform again. In conjoint analysis, cost (free vs. $17USD) had the highest impact on testing preference (Impact Score: 25.2; p = <0.001). A one-week time to test result notification was preferred to 90 minutes (Impact Score: -0.8; p = 0.03).

Conclusion: We found high acceptability of self-collection for STI testing among HIV PrEP clients in Vietnam. Cost was the most important factor affecting testing uptake. Expanding self-collection and lowering costs could improve STI testing in HIV PrEP programs.