SELPHI was prospectively registered with the ISRCTN (ref: ISRCTN 20312003). This suggests that HIVST may have the potential to increase testing uptake and frequency, particularly for those with complex relationships with clinical services. The decoupling of HIV testing and clinic attendance may be particularly valuable for MSM of minority ethnic backgrounds who are likely to experience anxiety and discomfort in clinic waiting rooms more acutely than White MSM due to concerns around implied disclosure.
HIVST responds to some service access barriers experienced by Asian, Black and Latin American MSM. HIVST was found to be acceptable and some interviewees suggested potential adaptations of the HIVST offer, such as packaging HIVST with at home sexually transmitted infections testing options. Discomfort in clinic waiting rooms was identified as a substantial barrier to accessing clinical services and many interviewees expressed preferences regarding the personal characteristics of healthcare providers. However, experiences of discomfort due to perceptions of ‘whiteness’ on the scene or experiences of racism may hinder the protective function the scene could play in developing norms influencing HIV testing behaviour. The gay scene was identified as an important site for learning about HIV and being exposed to norms reinforcing the importance of protective behaviours. Interviews were audio recorded, transcribed and then analysed using a thematic framework. Topics included HIV testing history, HIV testing patterns, experiences of accessing sexual health services, mental health, engagement with HIVST and SELPHI, and experiences of the gay scene. Twenty-nine qualitative interviews were conducted with Asian, Black and Latin American MSM who had participated in SELPHI, an HIVST randomised controlled trial. This study sought to understand the potential role of HIVST by exploring the experiences of Asian, Black and Latin American men who have sex with men (MSM) accessing the gay scene and the circulation of HIV testing norms experiences of accessing HIV testing services HIVST acceptability and preferences for intervention adaptations. Findings suggest the need for more targeted, culturally congruent PrEP dissemination strategies and PrEP prescription policies that acknowledge the various social locations and ecologies in which young Black gay, bisexual and other men who have sex with men reside.HIV self-testing (HIVST) could play an important role in improving access to testing and therefore reducing inequalities related to late diagnosis of HIV, while also improving access to HIV prevention interventions such as HIV pre-exposure prophylaxis. The second focused on the impact of participants’ social locations and perceptions of PrEP users based on their PrEP knowledge. The first centred on the ineffectiveness of institutions in disseminating PrEP information to participants. Our analysis revealed two interrelated barriers to PrEP knowledge and uptake. race, sexual orientation), interacted with individual, interpersonal and community contexts to shape their understanding. Intersectionality and the social ecological model allowed us to explore how social locations (e.g. We interviewed twenty-two young men and used a constructivist grounded theory approach to qualitatively analyse these young men’s PrEP knowledge. While research has explored the factors associated with their higher HIV exposure and the efficacy of STI/HIV prevention programmes, there remains a paucity of research on their knowledge of HIV prevention strategies such as PrEP. Despite significant advances in the HIV treatment and prevention landscape such as pre-exposure prophylaxis (PrEP), young Black-Canadian gay, bisexual and other sexual minority men continue to experience disproportionately high rates of HIV infection.