HIV testing is a cornerstone of prevention, reducing undiagnosed infection and facilitating early treatment. The study frames a particular concern that Indigenous gay, bisexual and other men who have sex with men (GBM) — specifically Māori participants in Aotearoa New Zealand — may experience barriers to accessing clinic-based sexual health services. To address accessibility issues, the study evaluated mail-out at-home self-collection using dried blood spots (DBS) as an alternative testing approach for HIV, syphilis and hepatitis C.
The rationale is that a self-collection, postal model could bypass some structural, cultural or logistical obstacles to clinic attendance and thereby reduce undiagnosed infection and improve engagement with care for populations facing access challenges.
The analysis used data from the Sex and Prevention of Transmission Study, a national HIV bio-behavioural surveillance survey of GBM conducted in 2022. At the end of the online questionnaire, participants were offered the opportunity to receive a mail-out at-home self-collection DBS kit for testing for HIV, syphilis and hepatitis C. Participants returned specimens using postage-paid courier bags.
From the population that self-identified as Māori, 495 participants started the survey. Of these, 384 participants (77.6%) progressed through the questionnaire to the section offering the DBS kit. Interest, requests, and actual return of DBS specimens were recorded sequentially to allow assessment of uptake at each step.
Among the 384 Māori participants who reached the DBS section, 246 (66.1%) indicated interest in receiving an at-home DBS kit. From those who expressed interest, 215 participants (87.4%) requested a kit and were mailed one.
A total of 85 DBS specimens were returned to the study team. This corresponds to 39.4% of the kits that were mailed and 22.1% of the Māori participants who reached the DBS question in the survey. The reported figures describe uptake at the interest, request, mailing, and return stages and indicate drop-off between mailing and specimen return.
The study assessed differences in DBS return rates by selected participant characteristics using univariate logistic regression. The key finding reported in the abstract was that Māori GBM who reported never having previously tested for HIV were less likely to return a DBS specimen compared with those who had a history of testing (odds ratio 0.37, 95% confidence interval 0.16–0.83).
No other subgroup analyses or multivariable-adjusted associations are reported in the abstract. Details on additional covariates analysed, if any, and their results were not provided in the source abstract.
On the basis of the reported return rate, the authors conclude that at-home self-collected DBS was acceptable to approximately one in five Māori GBM participants in this sample. They propose that mailed DBS collection could serve as a complementary option to clinic-based testing strategies for HIV and other sexually transmitted infections among Māori GBM, potentially increasing access for some individuals.
The finding that never-testers were less likely to return a DBS suggests that offering mail-out DBS alone may not fully overcome the barriers experienced by people who have never tested; additional engagement strategies may be needed to reach that subgroup.
The information available in the source (the PubMed abstract) reports primary uptake metrics and one univariate association. Specific methodological details and broader context were not reported in the abstract, including:
Because these items were not reported in the abstract, they cannot be assumed and would require consultation of the full text for confirmation.
Within the sampled group of Māori GBM participating in a national online surveillance survey, offering a mail-out at-home DBS kit for HIV, syphilis and hepatitis C resulted in expressed interest from two-thirds of those who reached the question, mailing of kits to most interested participants, and return of specimens by 39.4% of those mailed a kit (85 returned specimens; 22.1% of those who reached the DBS question).
The authors interpret these findings to mean that at-home self-collected DBS is an acceptable testing option for a meaningful minority of Māori GBM and could complement clinic-based testing services. The lower return rate among those who had never tested for HIV highlights a persistent gap and indicates that additional or alternative outreach and engagement strategies will be required to reach never-testers.
For program planners and clinicians, the study suggests feasibility and interest in postal DBS models among Indigenous GBM but underscores the need to review implementation details (support, instructions, follow-up, laboratory workflow and confirmatory testing pathways) and to consider tailored approaches to engage never-testers. The abstract does not provide outcome data on positive test results or linkage to care, which are critical for assessing public health impact and should be sought in the full text.