Electronic vending machines for delivering HIV and STI testing kits
Research type
Research Study
Full title
Acceptability and feasibility of electronic vending machines for delivering HIV self-testing and STI self-sampling kits: a mixed methods study
IRAS ID
306738
Contact name
Jaime Vera
Contact email
Sponsor organisation
University of Sussex
Duration of Study in the UK
0 years, 5 months, 31 days
Research summary
Research summary - HIV weakens the immune system against infection and cancer. In 2020, there were an estimated 37.7 million people living with HIV globally and 680,000 people died of HIV-related illnesses. In 2014 the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched their 95-95-95 target, which aims to ensure 95% of people who are HIV positive are aware of their status. Regular testing and early diagnosis facilitates prompt treatment, leading to improved survival rates and reduction in transmission to others. Approximately 1 million sexually transmitted infections (STIs) are diagnosed each day. Left untreated, they can lead to pelvic inflammatory disease, infertility and neonatal death.
In the UK, it is estimated that 1 in 16 people living with HIV are unaware they are positive and 42% of people diagnosed in 2019 were at a late stage of infection. In the UK, Brighton and Hove (B&H) has the highest prevalence of HIV outside of London (7.8% amongst 15 to 59 year-olds in 2019). These rates are higher for certain at-risk groups such as men who have sex with men (MSM) and individuals from a black, Asian and minority ethnic (BAME) groups.
In 2017, a novel strategy for HIV self-testing kit distribution was implemented via vending machines (VMs) in B&H with highly encouraging results. Since then, 4 further VMs have been installed. This study will involve mixed methods to investigate whether the use of VMs to deliver HIV self-testing and STI self-sampling kits offer an acceptable and practical adjunct to current community testing options using online questionnaires and semi-structured interviews. Potential contributions include establishing VMs as a successful strategy to increase testing that could be expanded and replicated to other venues across the UK and globally.
Lay summary of study results: Thank you to all participants who took part in this study. Our study title was: acceptability and feasibility of electronic vending machines for delivering HIV self-testing and STI self-sampling kits: a mixed methods study.The research was carried out by two separate teams across Brighton and Hove and Bristol, North Somerset and South Gloucestershire led by Professor Jaime Vera and Dr Joanna Kesten.In Brighton, this research was jointly funded by Brighton Sexual Health and Contraception, Department of Global Health and Infection at Brighton and Sussex Medical School, Martin Fisher Foundation and Brighton and Hove City Council. In Bristol, this research was funded by University Hospitals Bristol and Weston NHS Foundation Trust and supported by National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West at University Hospitals Bristol and Weston NHS Foundation Trust and NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at University of Bristol, in partnership with UK Health Security Agency (UKHSA). The study was sponsored by the University of Sussex. No competing interests are declared.
In the UK, it is estimated that 1 in 16 people living with HIV are unaware they are positive and 42% of people diagnosed in 2019 were at a late stage of infection. HIV self-test kits are at-home testing kits which give a reactive result within 20 minutes. Approximately 1 million sexually transmitted infections (STIs) are diagnosed each day. Some are treatable with antibiotics but if left untreated they can lead to pelvic disease and infertility. STI self-sample kits are where the swabs and samples are taken independently and then posted back to the laboratory for analysis. Our main question was looking at whether using vending machines to distribute HIV self-test kits and STI self-sample kits is an acceptable and feasible method of delivery.
The study took place from April 2022 to March 2023, over which time 2536 sexual health test kits were dispensed from a total of 11 vending machines (7 in Brighton, 4 in Bristol).
During the study, participants filled out a short online questionnaire on their background, their sexual history and their opinions on the vending machine and testing in this way, in return for a £10 high street voucher. They had the option to take part in a further 30 minute interview (either online or face to face) to discuss their experience of using the machine, for a further £20 high street voucher.
The STI self-sample kits were most popular (74% of vends). 78% of kits dispensed were among users aged 16–35 years and 56% identified as male. 68% and 59% of users had either not tested in the last 12 months or never tested for HIV and STIs. 51% of STI kits were returned via post, lower than the local online service (65%). 208 users completed questionnaires. Convenience, desire for instant access and increased confidentiality were the most common reasons for using machines. 92% of respondents thought the machines were user-friendly and 97% would recommend the service. Concerns about safety and privacy while using the machine were reported by 42% and 66% of respondents.
This study demonstrates that vending machines are an acceptable and effective means of accessing infrequent or never testers in the general population and can act as a horizontal intervention to tackle HIV and STIs. Research is needed to understand optimal machine locations to assure privacy and safety along with the long-term impact on sexual health services.No further research is currently planned.
You can read more about the study here:
Combined machine and survey results: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fsti.bmj.com%252Fcontent%252F100%252F2%252F91%2FNBTI%2FXuC4AQ%2FAQ%2F8be290a5-8541-416e-a90e-f8bfb24ae7f4%2F2%2FoU5vbIfsMV&data=05%7C02%7Cbrightonandsussex.rec%40hra.nhs.uk%7Cba790e4c604c43a55f8508dcf391b869%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638653054391920913%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=nzx53Dq53%2BU6rvP%2FxhvSn7tyiNxwE4b5SXx6UQOWyVE%3D&reserved=0
Brighton interview results: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fbmjpublichealth.bmj.com%252Fcontent%252F2%252F1%252Fe000598%2FNBTI%2FXuC4AQ%2FAQ%2F8be290a5-8541-416e-a90e-f8bfb24ae7f4%2F3%2FecnfMsjPxT&data=05%7C02%7Cbrightonandsussex.rec%40hra.nhs.uk%7Cba790e4c604c43a55f8508dcf391b869%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638653054391936134%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=MoGeXwvjB49YPxCjPuNkvdcvkOKlUXpOn6qigCakBGc%3D&reserved=0
Bristol interview results: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Fbmjopen.bmj.com%252Fcontent%252F14%252F6%252Fe084786.full%2FNBTI%2FXuC4AQ%2FAQ%2F8be290a5-8541-416e-a90e-f8bfb24ae7f4%2F4%2FIH7mPxkPzh&data=05%7C02%7Cbrightonandsussex.rec%40hra.nhs.uk%7Cba790e4c604c43a55f8508dcf391b869%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638653054391950612%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=m0Fso3luVwCB69gXasGmybCYI4vmoYkldG3AXY4pIe8%3D&reserved=0REC name
London - Brighton & Sussex Research Ethics Committee
REC reference
22/LO/0171
Date of REC Opinion
15 Mar 2022
REC opinion
Favourable Opinion