O08 Digital vending machines for delivery of HIV self-testing and STI self-sampling kits in Brighton, UK: a mixed methods study

Introduction Sexual health, encompassing HIV and STIs, remains a public health priority and relies on widely available testing to enable prompt diagnosis and treatment. Technology-based approaches to distribute STI tests have the potential to increase access to testing. We evaluated the acceptability and uptake of using vending machines (VMs) in community settings in Brighton, UK to distribute HIV self-test and STI self-sample kits. Methods This is a mixed methods study. Participants are self-recruited after using the VM, where a text message is sent with an online questionnaire. Those who filled out the questionnaire were invited to a subsequent semi-structured interview. Stakeholders were contacted separately. Participants under 18 were excluded. Data analysis took place on SPSS and NVivo, using a thematic approach. Full ethical approval was obtained IRAS 306738. Results 863 kits (260 HIV self-test, 603 combined HIV and STI self-sample) were dispensed by seven VMs over a ten month period (April 2022 to January 2023). These were to a predominantly male (451/863, 52%) and heterosexual (498/863, 58%) population. Return rate of the STI self-sample tests was 40%, significantly lower than the postal service (p=0.006). For HIV, 65% (560/863) of users had not tested in the last year, including 42% (362/863) having never previously tested. For STIs, 58% (497/863) had not tested in the last year, including 29% (248/863) who had never tested before. 69 participants completed the questionnaire, and 14 consented to interview. Acceptability was high, with 94% of users indicating they would recommend the service. Main benefits included convenience, speed, and privacy. Community stakeholders (n=5) demonstrated encouraging opinions but revealed technical practicalities (restocking and machine hardwiring) as barriers to implementation. Discussion The VMs are successful in reaching heterosexual populations and infrequent testers. Whilst further work to improve the technical functionality is required, acceptability is high. Further research is needed to inform widespread implementation.