Amsterdam 2015
Amsterdam 2015
Abstract book - Abstract - 2293
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Abstract #2293  -  Test & repeat
Session:
  45.1: Test & repeat (Parallel) on Friday @ 09.00-10.30 in C103 Chaired by Vincent Pelletier,
Sarah Skeen

Authors:
  Presenting Author:   Ms Janneke Bil - GGD Amsterdam / Public Health Service Amsterdam, Netherlands
 
  Additional Authors:   
Aim:
Self-tests (tests done autonomously by a person without involving a medical doctor or certified laboratory) are becoming increasingly available to the general public. However, the quality or linkage to care of most available self-tests is insufficient. We assessed HIV/STI self-test usage, determinants and whether usage increased over time among four populations in Amsterdam.
 
Method / Issue:
Questionnaires concerning demographics, sexual behavior and HIV/STI self-test usage were completed by: 1) inhabitants of Amsterdam participating in a representative population-based cross-sectional study in 2008 and 2012 (n=6,044) 2) participants included in a multi-ethnic population-based cohort study (HELIUS) in Amsterdam between 2010-2014 (n=14,312) 3) STI-clinic visitors participating in a bi-annual HIV-survey between 2007-2012 (n=5,655) and 4) men having sex with men (MSM) participating in the Amsterdam Cohort Studies (ACS) in HIV in 2007 (n=448) and 2013 (n=466). Self-test usage refers to the preceding 12 months, except for study 4 where it was measured in the preceding 6 months. Within each study population, the proportion of self-test usage was assessed and logistic regression analyses were used to identify determinants of usage.
 
Results / Comments:
Among inhabitants of Amsterdam, self-test usage increased from 0.9% (95%-CI:0.6-1.4%) in 2008 to 1.3% (95%-CI:1.0-1.8%) in 2012 (p-value <0.01). Of the HELIUS-participants, 1.2% (95%-CI:1.1-1.4%) used a self-test. Among STI-clinic visitors, self-test usage also increased, from 0.8% (95%-CI:0.4-1.7%) in 2007 to 2.1% (95%-CI:1.4-3.2%) in 2012 (p-value <0.01). Among MSM participating in the ACS, self-test usage remained stable over time, 1.1% (95%-CI:0.5-2.6%) in 2007 and 1.3% (95%-CI:0.6-2.8%) in 2013 (p-value 0.81). Among inhabitants of Amsterdam, MSM (aOR 2.31 [95%-CI:0.90-5.93]) and women (aOR 2.38 [95%-CI:1.34-4.25]) were more likely to have used self-tests than heterosexual men, as were those of younger age (19-30year reference aOR 31-41year: 0.81 [95%-CI:0.49-1.34] aOR 41-54year: 0.44 [95%-CI:0.23-0.83]) and those reporting higher numbers of sexual partners in the preceding 12 months (<2 partners reference aOR 3-5 partners: 4.63 [95%-CI:2.55-8.41] aOR >5 partners: 5.50 [95%-CI:3.03-9.99]). Among HELIUS-participants, younger age (18-23year reference aOR 24-29year: 0.79 [95%-CI:0.52-1.19] aOR 30-34year: 0.36 [95%-CI:0.21-0.60]) and an increasing number of lifetime sexual partners (<2 partners reference aOR 3-5 partners: 8.43 [95%-CI:4.55-15.64] aOR >5 partners: 9.53 [95%-CI:5.27-17.23]) were associated with self-test usage. Furthermore, Surinamese (aOR 1.88 [95%-CI:1.15-3.07]) and Ghanaian (aOR 2.11 [95%-CI:1.09-4.07]) participants were more likely to have used self-tests than Dutch participants. Among STI-clinic visitors, MSM (aOR 2.37 [95%-CI:1.31-4.29]) and women (aOR 2.32 [95%-CI:1.39-3.86]) were more likely to have used self-tests than heterosexual men. Among MSM participating in the ACS, those reporting higher numbers of sexual partners in the preceding 6 months (<2 partners reference OR 3-5 partners: 9.77 [95%-CI:1.20-79.85] OR >5 partners: 1.31 [95%-CI:0.08-21.08]) were more likely to have used self-tests.
 
Discussion:
HIV/STI self-test usage was relatively low but increased over time among inhabitants of Amsterdam and STI-clinic visitors. Furthermore, self-test usage appears higher among those at increased risk of HIV/STIs (i.e., younger age, engaging in sexual risk behavior). Our study strengthens the need for the development of information campaigns on self-testing and linkage to care programs for good quality tests.
 
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