Human immunodeficiency virus prevention and testing strategies among men who have sex with men in the UK: the PANTHEON research programme including the SELPHI RCT

Background Rates of human immunodeficiency virus diagnoses in UnitedKingdom men who have sex with men were at a 10-year high in 2014; many recent infections indicated ongoing transmission. There was a need to increase testing rates, reduce late diagnosis and understand how to best allocate human immunodeficiency virus prevention resources. Objective We aimed to assess (1) the feasibility of human immunodeficiency virus self-testing among men who have sex with men, (2) whether the offer of free human immunodeficiency virus self-testing resulted in earlier diagnosis of human immunodeficiency virus in an online randomised controlled trial, (3) the cost-effectiveness of strategies for preventing human immunodeficiency virus in men who have sex with men, including free human immunodeficiency virus self-testing. Design We produced a systematic evidence map and conducted focus groups and interviews with men who have sex with men and relevant stakeholders to identify barriers and facilitators to human immunodeficiency virus self-testing. We conducted an internet-based randomised controlled trial (a human immunodeficiency virus Self-testing Public Health Intervention to assess whether free human immunodeficiency virus self-testingwith reminders results in earlier diagnosis of human immunodeficiency virus compared with standard of care. We evaluated the cost-effectiveness of human immunodeficiency virus prevention strategies in men who have sex with men in the UnitedKingdom using a simulation model. Data sources Databases included MEDLINE, EMBASE, Global Health, Social Policy and Practice, PsycInfo, Health Management Information Consortium, EBSCO CINAHL Plus, Cochrane Library and Web of Science. Review methods Searches combined key terms relating to human immunodeficiency virus with terms related to self-testing. Data were manually extracted through a standard form and then entered into an open-access relational map (HIVST.org). Setting Internet-based study conducted in England and Wales. Participants Participants were men (including trans men) and trans women aged ≥ 16 years old, resident in England or Wales, and not known to be human immunodeficiency virus-positive, who had ever had anal sex with a man. The qualitative work also included human immunodeficiency virus service providers and commissioners. Intervention At baseline participants were randomised (randomisation A) to the offer of a single, free baseline human immunodeficiency virus self-test versus no fre