Uptake of at-home self-collected dried blood spots for HIV, hepatitis C and syphilis screening among Māori gay, bisexual and other men who have sex with men in Aotearoa New Zealand: an observational epidemiological study

BACKGROUND: HIV testing is an integral component of prevention, reducing undiagnosed infection and promoting early treatment. Indigenous gay, bisexual and other men who have sex with men (GBM) are at increased risk of HIV and sexually transmitted infections (STIs), but may experience difficulties accessing clinical services. At-home blood-based self-collection may offer an alternative that bypasses such barriers. This study aimed to explore uptake of dried blood spots (DBS) among Indigenous Māori GBM in Aotearoa New Zealand. METHODS: The Sex and Prevention of Transmission Study is a national HIV bio-behavioural surveillance survey of GBM. At the end of the 2022 online questionnaire, participants were offered a mail-out at-home self-collection DBS kit for HIV, syphilis and hepatitis C. Specimens were returned using postage-paid courier bags. We assessed interest in DBS, DBS requests and DBS returns among Māori participants. We compared differences in DBS return rates by select characteristics using univariate logistic regression. RESULTS: There were 495 participants who started the survey and self-identified as Māori. Of the 77.6% (n = 384) reaching the DBS section, 66.1% (n = 246) showed an interest in DBS. Of these, 87.4% (n = 215) requested and were sent a DBS kit. Eighty-five specimens were returned, 39.4% of those sent a kit and 22.1% of those reaching the DBS question. Māori GBM reporting never testing for HIV (OR 0.37, 95% CI 0.16-0.83) were less likely to return a DBS. CONCLUSION: At-home self-collected DBS was acceptable to approximately one in five Māori GBM participants, and could complement clinic-based HIV and STI testing.