HIV and syphilis self-testing to support implementation of patient-delivered partner therapy for bacterial STI partner treatment among sexual minoritized men.

Background: Patient-delivered partner therapy (PDPT) is a presumptive treatment mechanism for sexual partners of patients diagnosed with chlamydia and/or gonorrhea; however, successful implementation to sexual minoritized men (SMM) is impeded by concerns about missed opportunities for HIV and syphilis testing. As such, we explored barriers and facilitators of including a dual HIV and syphilis self-testing device with PDPT among SMM residing in Oklahoma, US.

Methods: In 2023, in-depth interviews were conducted with HIV-negative or unknown status SMM (n = 20; Mage = 33.4; 90% cisgender; 45% Black, Latino, or multiracial) eliciting responses about access to care, at-home HIV/STI testing, and PDPT. Data were analyzed using the rigorous and accelerated data reduction (RADaR) technique.

Results: SMM reported inadequate access to culturally competent providers. Despite mixed perceptions, altruism led most participants to indicate the importance of notifying a partner of a bacterial STI diagnosis. Delivering PDPT with an HIV and syphilis self-testing kit was perceived to increase confidentiality, improve access to appropriate care, decrease time to partner treatment, reduce exposure to anti-gay and HIV/STI stigmas, and avoid insurance and cost challenges. Participant intervention requests included the need for multimodal educational materials, a letter from a healthcare provider with contact information, medication and safety information, discrete packaging, and a communication guide.

Conclusions: Intervention requests by SMM will be important for maximizing successful uptake of PDPT with partner HIV and syphilis self-testing. Additional research with healthcare providers is needed to identify potential implementation strategies to support prescribing behaviors.