Preferences of Men Who Have Sex With Men Toward the Distribution of HIV Self-Test Kits Through Social Networks: A Discrete Choice Experiment

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Abstract
Objective: Social network distribution of HIV self-test (HIVST) kits uses social networks to increase HIV testing among marginalized populations, such as men who have sex with men (MSM). Using a discrete choice experiment, we identified factors influencing MSM's willingness and decision making in HIVST kit distribution. Design: An online discrete choice experiment survey was conducted among MSM in Australia (December 2023−May 2024) through online/offline advertisements. Methods: Participants completed 7 choice sets, each containing 2 hypothetical scenarios for HIVST kits distribution described by attributes such as cost, location, training, support system, and self-reporting methods. Mixed logit models and latent class analysis explored preference heterogeneity across language (English vs. non-English first language) and nativity (Australian-born vs. overseas-born) groups. Results: There were 251 participants, including 140 overseas-born MSM, with a mean age of 36.5 years (SD = 11.9). Participants who did not speak English as their first language (29/251, 12%) showed a lower preference for paid HIVST kits ($30 or $60 for 3 kits) and online video chats with sexual health professionals as pretest support. Overseas-born participants preferred not to attend 30-minute or 1-hour training sessions on distributing HIVST kits. They did not like accessing HIVST kits from hospitals. Class 1 (‘Cost-conscious and minimal support seekers’; 61.7%) were willing to pay up to $30 for 3 kits, while Class 2 (‘Subsidy-dependent and structured support seekers’; 38.3%) disliked costs and self-reporting results by phone. Conclusions: Increasing participation in social network distribution of HIVST kits will require free or subsidized kits. Tailored support systems should prioritize overseas-born MSM with limited English proficiency.
Funding Information
  • Australian National Health and Medical Research Council (GNT1193955)
  • Australian National Health and Medical Research Council (GNT1172873)
  • Australian National Health and Medical Research Council (GNT1172900)

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