Home / Resources / Journal Articles / Acceptability of an existing online sexually transmitted and blood-borne infection testing model among gay, bisexual and other men who have sex with men in Ontario, Canada

Acceptability of an existing online sexually transmitted and blood-borne infection testing model among gay, bisexual and other men who have sex with men in Ontario, Canada

View Summary Sheet

Click here to read the full article. 

Research theme(s)
Internet Based Testing

Joshun JS Dulai, Mark Gilbert, Nathan J Lachowsky, Kiffer G Card, Ben Klassen, Jessy Dame, Ann N Burchell, Catherine Worthington, Aidan Ablona, Praney Anand, Ezra Blaque, Heeho Ryu, MacKenzie Stewart, David J Brennan, and Daniel Grace

Digital Health. DOI: 10.1177/20552076231173557.

Objectives
Gay, bisexual and other men who have sex with men (GBM) are disproportionately affected by sexually transmitted and blood-borne infections (STBBI) due to stigma and other factors such as structural barriers, which delay STBBI testing in this population. Understanding acceptability of online testing is useful in expanding access in this population, thus we examined barriers to clinic-based testing, acceptability of a potential online testing model, and factors associated with acceptability among GBM living in Ontario.

Methods
Sex Now 2019 was a community-based, online, bilingual survey of GBM aged ≥15. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were calculated using modified Poisson regression with robust variances. Multivariable modelling was conducted using the Hosmer-Lemeshow-Sturdivant approach.

Results
Among 1369 participants, many delayed STBBI testing due to being too busy (31%) or inconvenient clinic hours (29%). Acceptability for online testing was high (80%), with saving time (67%) as the most common benefit, and privacy concerns the most common drawback (38%). Statistically significant predictors of acceptability for online testing were younger age (PR  =  0.993; 95%CI: 0.991–0.996); a greater number of different sexual behaviours associated with STBBI transmission (PR  =  1.031; 95%CI: 1.018–1.044); identifying as an Indigenous immigrant (PR  =  1.427; 95%CI: 1.276–1.596) or immigrant of colour (PR  = 1.158; 95%CI: 1.086–1.235) compared with white non-immigrants; and currently using HIV pre-exposure prophylaxis (PrEP) compared to not currently using PrEP (PR  =  0.894; 95%CI: 0.828–0.965).

Conclusions
Acceptability of online testing was high among GBM in Ontario. Implementing online STBBI testing may expand access for certain subpopulations of GBM facing barriers to current in-person testing.