Factors associated with intention to use self-sampling services for HIV and other sexually transmitted and blood-borne infections among men who have sex with men in British Columbia, Canada​

Background: Population subgroups that are likely to use self-sampling services for HIV and other sexually transmitted and blood-borne infections (STBBIs) are not well-characterized in Canada. Given provincially organized health services, we assessed factors associated with intention to use self-sampling services among gay, bisexual, and other men who have sex with men (gbMSM) in British Columbia.

Methods: We analysed data from the 2019 Sex Now online survey of gbMSM aged >=15 years in Canada. Respondents indicated how likely they would use a testing service by ordering a self-collection kit online that would be mailed to their addresses and shipped to a lab for testing. We assessed the association between intention to use self-sampling (i.e., likely/very likely vs. other responses) and explanatory variables including sociodemographic characteristics, sexual behaviors, healthcare access and testing. Using multivariable logistic regression, we selected our model using automated backward elimination based on Akaike information criterion, after retaining predictors identified in the literature.

Results: Overall, 758 respondents had complete responses to survey components of interest, with a mean age of 39.39 years (SD: 14.25). Among these, 66.1% (501) indicated intention to use self-sampling services. In multivariable analysis, age >=30 years (adjusted odds ratio [AOR] 1.64, 95% CI 1.11-2.42), having last STBBI test between 4-6 months prior to the survey (AOR 1.82, 95% CI 1.11-3.05), and experiencing delayed testing due to access barriers (e.g., cost, distance, inconvenient hours, fear of judgement etc.) (AOR 2.53, 95% CI 1.77-3.65) were associated with higher odds, while participants with a bachelor’s degree had lower odds of intending to use self-sampling services (AOR 0.46, 95% CI 0.248-0.74) (Figure 1).

Conclusion: The high intention to use self-sampling for HIV and other STBBIs suggests that the service can potentially increase access to testing services for gbMSM in BC, especially for those experiencing delayed testing due to health service access barriers.