Evidence map›Paper›PMID 34671752›Full record

ArticleThe Lancet regional health. Western Pacific2021

The longer-term effects of access to HIV self-tests on HIV testing frequency in high-risk gay and bisexual men: follow-up data from a randomised controlled trial.

Ye Zhang, Muhammad S Jamil, Kirsty S Smith, Tanya L Applegate, Garrett Prestage, Martin Holt, Phillip Keen, Benjamin R Bavinton, Marcus Chen, Damian P Conway and 11 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Western Pacific, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Ye ZhangKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Muhammad S JamilGlobal HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland.
Kirsty S SmithKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Tanya L ApplegateKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Garrett PrestageKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Martin HoltCentre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia.
Phillip KeenKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Benjamin R BavintonKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Marcus ChenMelbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
Damian P ConwayKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Handan WandKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Anna M McNultySydney Sexual Health Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia.
Darren RussellCairns Sexual Health Service, Cairns North, QLD, Australia.
Matthew VaughanACON, Sydney, NSW, Australia.
Colin BatrouneyThorne Harbour Health, Melbourne, VIC, Australia.
Virginia WisemanKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Christopher K FairleyMelbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia.
Andrew E GrulichKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Matthew LawKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
John M KaldorKirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Rebecca J GuyKirby Institute, UNSW Sydney, Sydney, NSW, Australia.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundA wait-list randomised controlled trial in Australia (FORTH) in high-risk gay and bisexual men (GBM) showed access to free HIV self-tests (HIVSTs) doubled the frequency of HIV testing in year 1 to reach guideline recommended levels of 4 tests per year, compared to two tests per year in the standard-care arm (facility-based testing). In year 2, men in both arms had access to HIVSTs. We assessed if the effect was maintained for a further 12 months.

methodsParticipants included GBM reporting condomless anal intercourse or > 5 male partners in the past 3 months. We included men who had completed at least one survey in both year 1 and 2 and calculated the mean tests per person, based on the validated self-report and clinic records. We used Poisson regression and random effects Poisson regression models to compare the overall testing frequency by study arm, year and testing modality (HIVST/facility-based test).

findingsOverall, 362 men completed at least one survey in year 1 and 343 in year 2. Among men in the intervention arm (access to HIVSTs in both years), the mean number of HIV tests in year 2 (3⋅7 overall, 2⋅3 facility-based tests, 1⋅4 HIVSTs) was lower compared to year 1 (4⋅1 overall, 1⋅7 facility-based tests, 2⋅4 HIVSTs) (RR:0⋅84, 95% CI:0⋅75-0⋅95, p=0⋅002), but higher than the standard-care arm in year 1 (2⋅0 overall, RR:1⋅71, 95% CI:1⋅48-1.97, p<0⋅001). Findings were not different when stratified by sociodemographic characteristics or recent high risk sexual history.

interpretationIn year 2, fewer HIVSTs were used on average compared to year 1, but access to free HIVSTs enabled more men to maintain higher HIV testing frequency, compared with facility-based testing only. HIV self-testing should be a key component of HIV testing and prevention strategies.

fundingThis work was supported by grant 568971 from the National Health and Medical Research Council of Australia.

Indexed as

Gay and bisexual menHIVHIV self-testingRandomised controlled trial

Identifiers

PMID34671752
PMCPMC8484892

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.