(P341) Digital vending machines for delivery of HIV self-testing and STI self-sampling kits in Brighton, UK: a mixed methods study

Background

Sexual health, encompassing HIV and STIs, remains a public health priority and relies on widely available testing to enable prompt diagnosis and access to treatment. Technology-based approaches to distribute STI tests have potential to increase access to testing. We evaluated the acceptability and uptake of using vending machines in community settings in Brighton, UK to distribute HIV self-test and STI self-sample kits.

Methods

This is a mixed methods study. Participants are self-recruited after using the VM, where a text message is sent with an online questionnaire link. Those who filled out the questionnaire were invited to a subsequent semi-structured interview. Stakeholders were contacted separately. Participants under 18 were excluded from the study. Data analysis took place on SPSS and NVivo, using a thematic approach. Full ethical approval was obtained IRAS 306738.

Results

611 kits (194 HIV self-test, 417 combined HIV and STI self-sample) were dispensed over an eight month period (April to November 2022). These were to a predominantly male (346/611, 57%) and heterosexual (350/611, 57%) population. Return rate of the STI self-sample tests was 38%, similar to the local postal service (p=0.5). 69 participants completed the questionnaire, and 14 consented to interview. The vending machine was successful at engaging infrequent testers with 59% (41/69) of users not having had a HIV test in the last year, including 43% (30/69) having never previously tested. For STIs, 52% (36/69) had not had a test in the last year, including 28% (19/69) who had never tested before. Acceptability was high, with 94% of users indicating they would recommend the service to a friend. Main benefits included convenience, speed, and privacy. Community stakeholders (n=5) demonstrated encouraging opinions but revealed technical practicalities (restocking and machine hardwiring) as barriers to implementation.

Conclusion

The VMs are successful in reaching heterosexual populations and infrequent testers. Whilst further work to improve the technical functionality is required, acceptability is high. Further research is needed to inform widespread implementation.