Introducing vending machines for HIV self-testing and STI self-sampling kits

Project aims

We wanted to:

• understand what people using the machines thought of the service
• see if they thought vending machines were a practical way of accessing tests
• explore the reasons why they used a vending machine for HIV and STI testing
• establish how many kits were taken from vending machines and then sent to a laboratory and what the results were
• understand who got testing kits from the vending machines

What we did

Information about who used the machines, the kits taken, and test results were taken from the machine database and clinic records.

We invited vending machine users to complete an online questionnaire about their views and experiences of using the machine. The link for our questionnaire was included in a text message sent to people when they requested a test kit.

Details of the questionnaire were included on the machine interface, in posters at the machine and via social media posts by community partners.

To get a more in-depth understanding of machine acceptability, we also interviewed machine users, sexual health service staff, venue staff and local authority commissioners.

How we involved people

We ran workshops with members of the public from three communities (young people, men-who-have-sex-with-men and people of black African and black Caribbean heritage). This helped us find the best places to put the vending machines, co-design promotional materials and refine the interface on the machines (originally designed by the team in Brighton and Hove).

What we found and what this means

Vending machine users found the service acceptable and easy to use. Uptake was high in public settings, especially among young people as well as men-who-have-sex-with-men but who otherwise do not regularly test for STIs or HIV.

There were some challenges associated with running the service at the start. These included its quick introduction, a high number of users, limited resources and engagement with sexual health service staff. However, once these were resolved the service was easy to manage.

The number of machine-issued kits that were returned and the number of positive results found were lower when compared with the local postal kit service. This suggests either a lower risk of infection or people taking tests to use later, because they were available.

People using the service valued the machines for their convenience and instant access, but it’s possible that concerns about privacy and safety could have deterred some from accessing them. Users also raised issues of machine maintenance.

Venue staff found the machines acceptable once they had clear processes for managing them in place. Sexual health service staff identified challenges with the implementation of the service related to the limited involvement of their whole team in how the intervention was planned and developed.

Overall, we found that vending machines could be useful for improving access to sexual health testing among underserved communities who rarely (or never) undergo sexual health testing. They could also be used to deliver other sexual health services, such as contraception.

What next?

Steps to improve users’ privacy are needed to improve the service. We also need to understand more about how much the service costs and ensure targeted promotion of the machines among people less likely to access clinics for testing.

More work is also needed to understand the views of young people and people from black African and black Caribbean communities.