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Which gay and bisexual men might use internet-based testing for HIV and STIs in Canada?
Nov 20, 2013 by Mark Gilbert, Physician Epidemiologist, Clinical Prevention Services, BCCDC
There are only a few internet-based testing programs that have been designed with gay and bisexual men in mind. While we know that gay and bisexual men do use these services, we don’t really know what impact these services have at a population level. We also don’t know whether internet-based testing reinforces or reduces existing health inequities for gay and bisexual men; for example, are the men who use it those who already have good access to testing, or will it be used by the men who need it most?
The BCCDC is currently developing a new and innovative internet-based testing service called Get Checked Online. Through this service, clients will be able to log into a website, answer some questions about their sexual history, print a lab requisition, go to a participating LIfeLabs location to give specimens, and then get negative results online and positive results over the phone.
As gay and bisexual men are a key audience for Get Checked Online (launching early 2014), this led us to question which gay and bisexual men might use internet-based testing for HIV and STIs?
Summary of evidence
The BCCDC partnered with the Community-Based Research Centre for Gay Men’s Health to add questions about internet-based testing to the 2011 Sex Now survey, the largest online survey of gay and bisexual men in Canada (over 8,000 men in 2011). Following a brief description of internet-based testing, we asked men in the survey how likely they would be to use the service.
The findings from the survey, published last week in the Journal of Medical Internet Research, are encouraging. We found that 72% of gay and bisexual men in Canada said they would be likely to use the service once available, and this proportion was high across all sub-groups of men (generally ranging between 67-77%, with a few exceptions). This suggests that internet-based testing may not reinforce inequities along demographic or behavioural lines (e.g., by ethnicity, income, education, rural/urban residence, or level of risky sexual behaviour).
When we looked more closely at the data, we found that intending to use internet-based testing was most strongly associated with being tech-savvy (defined as using mobile phones for texting or to access the web, looking for health information or sex partners online) and delaying or avoiding testing due to privacy or access barriers (e.g., didn’t want to see a doctor or nurse, couldn’t get anonymous testing, not able to visit during clinic hours, long wait list for appointment).
Implications for practice
While these findings suggest that internet-based testing will help to alleviate some of the barriers men face in accessing STI or HIV testing in the real world, it also points out that we still need to think about how to make the service easy and simple to use by, and appealing to, less tech-savvy men.
While we will still need to see if intention to use will equate to actual use once Get Checked Online goes live, the take home message for us is that we’re on the right track, and that internet-based testing has the potential to improve access to testing for gay and bisexual men in BC.
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Categories: New knowledge