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Correspondence to Janneke P Bil, Department of Infectious Diseases Research and Prevention, Public Health Service of Amsterdam, 1000 CE Amsterdam, The Netherlands; [email protected]
Introduction
Self-tests are tests that can be performed and interpreted autonomously by laypersons without involving healthcare professionals or certified laboratories.1 The WHO currently recommends the usage of self-tests for HIV infections (HIVST) as an additional approach to HIV testing services, as it could increase HIV testing rates.1 2 However, ensuring linkage to confirmatory testing and specialist care for those with a positive HIVST result remains a concern.
Within Europe, migrants represent a significant group in the HIV epidemic, and migrants are more likely to be undiagnosed or diagnosed late compared with non-migrants.3 HIVST may help overcome the barriers migrants encounter in accessing traditional testing services and therefore increase HIV testing rates among this group.1 4
To gain more insight into the recent usage of purchased HIVST by migrants living in Europe, we studied its prevalence and determinants among migrants living in the UK, France and the Netherlands. Furthermore, we studied the HIVST positivity rate and the extent to which users attend professional healthcare providers for confirmation testing to gain insight into linkage to care among HIVST users.
Methods
We included participants of the web-based community survey of the aMASE (advancing Migrant Access to health Services in Europe) study. Detailed information on the aMASE study is provided elsewhere.5 6 Briefly, the cross-sectional aMASE community survey aimed to identify the structural, cultural and financial barriers to HIV prevention, diagnosis and treatment in migrant populations. The community survey was promoted between April 2014 and July 2015 via social marketing and community participatory methods in nine countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain and the UK), although migrants aged 18 or older living in all countries of the WHO European area were eligible. Migrants were defined as foreign-born individuals intending to live in their current country of residence for ≥6 months. Participants completed a questionnaire (available in 14 languages) which included (1) detailed sociodemographic data and extensive migration history data, (2) sexual and HIV risk behaviour, (3) use of health services, and (4) experiences of living with HIV, including stigma and discrimination. HIVST questions were only included...