Perceptions of and intentions to use a recently introduced blood-based HIV self-test in France

An estimated 28,000 French people infected with HIV remain undiagnosed, leading to HIV transmission and late-stage HIV infections. An over-the-counter HIV self-test has been available since September 2015. We thus aimed to explore people's perceptions of and intentions to use the test. An anonymous online questionnaire, targeting the general population and men who have sex with men (MSM) was distributed between November 2015 and January 2016. It explored at-risk sexual behavior, perceptions of the HIV self-test, and past and intended future use. A total of 1,082 participants completed 90% of the questionnaire (67.1% male, 32.4% female, 0.5% other; mean age 32.8 +/- 12 years). 44.8% were MSM. 41.5% declared that they did not always use or make their partner use a condom in the case of penetration with someone other than their usual partner (if applicable). 9.9% had already used the HIV self-test, with this proportion being higher in multivariate analysis for individuals with a monthly income exceeding Euro1,000 and those declaring to be informed about HIV. 38.5% stated their intention to use the self-test in the coming month or year; in multivariate analysis, this proportion was lower for MSM and higher for those who did not always use or make their partner use a condom in the case of penetration with someone other than their usual partner. The majority (68.4%) underestimated the testing delay to rule out HIV infection. The most frequently cited concerns were that self-test does not test for other sexually transmitted infections (49.5%) and is not free of charge (44.4%), and that users are left alone with the result (41.0%). The HIV self-test was identified as a useful tool by different at-risk populations; it may therefore enhance the number of diagnoses. The test delay must be appropriately communicated to users, while a lower purchase price may increase usage.