HIV/STI testing preferences for young black men who have sex with men in the Southeastern United States: implications for a post COVID-19 era.

Abstract

PURPOSE\nLittle is known regarding HIV/STI testing preferences for location, staffing, and hours of operation among young black men who have sex with men (YBMSM) in the Southeastern U.S, a population at high risk for HIV/STIs. We used a discrete choice experiment to explore these preferences.\n\n\nMETHODS\nYBMSM ages 16-35 in Birmingham, Alabama and Jackson, Mississippi completed online surveys evaluating their preferences (best/worst) for HIV/STI testing locations, staffing, hours, method of results notification, and cost. They also selected preferred combinations of these variables through choice tasks. Results were analyzed using joint best/worst and discrete choice experiment models.\n\n\nRESULTS\nBetween June 2018-December 2019, participants in Alabama (n = 54) and Mississippi (n = 159) completed online surveys. Both groups preferred stationary testing locations over mobile testing vans, with the most significant difference favoring STI testing-only clinics in Mississippi and local health departments in Alabama (p < 0.001). Technician-performed tests or self-testing were significantly less preferred compared to clinician-performed testing for both groups (p < 0.0001 and p < 0.0001, respectively). Free testing and phone results notification (versus text) were preferred by both groups. The most desirable combination among all participants was weekday clinician-performed testing at the health department for $5.\n\n\nCONCLUSION\nYBMSM in the Southeastern U.S. prefer traditional testing locations staffed by experienced personnel. Combination choices are influenced by services that are low- or no-cost. More research is needed to inform the best way(s) to provide affordable, high-quality HIV/STI testing services for YBMSM, particularly in the post-COVID-19 era when sexual healthcare delivery models are evolving toward home-based and remote-health focused strategies.