Introduction:
HIVST is a new approach, enabling individuals to test themselves for HIV in a location and at a time of their choosing using a rapid diagnostic test. HIVST has the potential to increase testing uptake and frequency. This study aims to understand the perspectives of key informants on the future implementation of HIVST.

Methods:
To inform development of an intervention for use in an RCT recruiting men who have sex with men (MSM) and transgender people, 17 in-depth interviews were conducted with key informants (KIs) including NHS clinical staff in HIV and STI services, voluntary sector service providers and service commissioners. Interviews were transcribed verbatim and analysed using a thematic framework analysis. 

Results:
KIs valued HIVST for providing patients with additional choice. Careful attention to intervention design was considered important as local context and client group shaped anticipated patient responses to HIVST. Interventions should deliver HIVST through integrated approaches that provide direct pathways into additional diagnostic services and HIV care. Anticipated impacts were a loss of support from face-to-face services, the possibility of increased risk of self-harm and reduced STI detection. Conversely HIVST was also assumed to increase potential for patient empowerment.

Discussion:
HIVST interventions should be responsive to context, taking into account both local and national needs. Concerns centred on potential negative impacts, indicating that innovative service delivery mechanisms which address these may be key to KI buy-in for eventual HIVST implementation and patient outcomes.

What are the perspectives of key informants on the implementation of HIV self-testing (HIVST) in England? A qualitative study of barriers, facilitators and anticipated impacts

The Joint Annual Conference of the British Association for Sexual Health and HIV & the Society for the Study of Sexually Transmitted Diseases in Ireland