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 using HIV Pre-Exposure Prophylaxis 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 Pre-Exposure Prophylaxis clients in Hanoi, Vietnam.

Methods: From January to December 2022, men who have sex with men 16 years 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 8 hypothetical testing profiles across 5 testing attributes; each profile was rated on a Likert scale (0-5) to create an impact score. Differences between attributes were assessed using a 2-sided, 1-sample t test of the impact score.

Results: There were 529 participants enrolled; all were male. Specimens from 3 sites were provided by 97.9% (518 of 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. US $17) had the highest impact on testing preference (impact score: 25.2; P < 0.001). A 1-week time to test result notification was preferred to 90 minutes (impact score: -0.8; P = 0.03).

Conclusions: 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.