Individuals can order a sampling kit online, take their own sample and mail it back for laboratory analysis. Negative results are communicated by text message and reactive results by a phone call from a trained member of staff, who helps with linkage to care.
This is therefore home sampling, rather than home testing. (The sale of home testing kits was legalised this month, although no licensed kits are available yet.)
Over eleven months, just under 10,000 individuals requested a kit, with two thirds returning a sample. The service was mostly used by men who have sex with men – fewer than 5% of samples were returned by African people. Uptake of testing was very closely linked with marketing activities, such as advertising and use of social media.
Around 1 in 60 of the returned samples (1.7%) were HIV positive, with especially high rates amongst those African people who did use the service (3.6%). There was good evidence of linkage to care for three-quarters of those who tested positive.
Participants didn’t seem to have problems providing a fingerprick blood sample and surveys showed that users were very satisfied with the service. The project seems to attract people who don’t like using sexual health clinics – one third had never tested before.
Two other home sampling projects have also reported similar results.
Taken together, they show that home sampling is feasible and acceptable in the UK, especially to gay men – it is not clear whether the limited engagement of African people is due to there being fewer African-specific media channels to promote the service in, or whether the offer is less appealing for other reasons.
And it remains to be seen whether home sampling is simply part of the preparation for true home testing, or whether it is an option that will be retained.