A Perspective on Home-Based Sexual Health Care: Evidence, Access, and Future Directions

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Abstract

Purpose

This perspective explores the impact of home-based sexual health services on accessibility to STI and HIV testing for priority populations. This study evaluates home-based services as independent care options and as complementary components of traditional clinic-based care.

Recent Findings

Challenges for persons to attend clinic-based sexual health care can be overcome by offering lower threshold home-based sexual health care. Implementing home-based services has successfully reached priority populations, including previously untested men who have sex with men (MSM) and individuals with a high exposure risk for sexually transmitted infections (STI) including human immunodeficiency virus (HIV), attending location-based sexual health care. A challenge in home-based services is to ensure equitable care, such as for individuals with limited access to digital resources or low health literacy.

Summary

While home-based sexual health services enhance the accessibility of sexual healthcare, to ensure equitable care, research into the needs of still underserved populations and subsequent tailoring of the care offered, is needed. Continuous monitoring and evaluation of the implementation of home-based services may maximize the advantages of this promising type of care.

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Most cited references 18

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Sex in the Time of COVID-19: Results of an Online Survey of Gay, Bisexual and Other Men Who Have Sex with Men’s Experience of Sex and HIV Prevention During the US COVID-19 Epidemic

Rob Stephenson, Tanaka M D Chavanduka, Matthew Rosso … (2020)

This paper presents data from a recent cross-sectional survey of gay, bisexual and other men who have sex with men (GBMSM) in the US, to understand changes in sexual behavior and access to HIV prevention options (i.e. condoms and pre-exposure prophylaxis (PrEP)) during the COVID-19 lockdown period. The Love and Sex in the Time of COVID-19 survey was conducted online from April to May, 2020. GBMSM were recruited through advertisements featured on social networking platforms, recruiting a sample size of 518 GBMSM. Analysis considers changes three in self-reported measures of sexual behavior: number of sex partners, number of anal sex partners and number of anal sex partners not protected by pre-exposure prophylaxis (PrEP) or condoms. Approximately two-thirds of the sample reported that they believed it was possible to contract COVID-19 through sex, with anal sex reported as the least risky sex act. Men did not generally feel it was important to reduce their number of sex partners during COVID-19, but reported a moderate willingness to have sex during COVID-19. For the period between February and April–May 20,202, participants reported a mean increase of 2.3 sex partners during COVID-19, a mean increase of 2.1 anal sex partners (range − 40 to 70), but a very small increase in the number of unprotected anal sex partners. Increases in sexual behavior during COVID-19 were associated with increases in substance use during the same period. High levels of sexual activity continue to be reported during the COVID-19 lockdown period and these high levels of sexual activity are often paralleled by increases in substance use and binge drinking. There is a clear need to continue to provide comprehensive HIV prevention and care services during COVID-19, and telehealth and other eHealth platforms provide a safe, flexible mechanism for providing services.

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Barriers to HIV testing in Europe: a systematic review.

J.-C. Fontaine, Françoise F Hamers, Marleen Temmerman … (2010)

In the European Union (EU) and neighbouring countries, HIV/AIDS, of all infectious diseases, has one of the highest morbidity and mortality rates. An estimated 30% of people living with HIV are unaware of their infection, and may therefore not benefit from timely treatment or may transmit HIV to others, unknowingly. Evidence shows that opportunities are being missed to diagnose HIV infections in EU Member States, particularly in regular health care settings. There is a need to better understand the barriers to HIV testing and counselling with the aim to contribute to the decrease of the number of undiagnosed people. A systematic review of literature on HIV testing barriers in Europe was conducted, applying a free text strategy with a set of search terms. A total of 24 studies published in international peer-reviewed journals and meeting the review's eligibility criteria were identified. Fourteen studies report on barriers at the level of the patient; six on barriers at health care provider level and seven on institutional barriers referring to the policy level. The barriers described are centralized around low-risk perception; fear and worries; accessibility of health services, reluctance to address HIV and to offer the test; and scarcity of financial and well trained human resources. Some barriers to HIV testing and counselling have been illustrated in the literature. Nevertheless, there is lack of structured information on barriers considering (i) legal, administrative and financial factors, (ii) attitudes and practices of health care providers and (iii) perception of patients. Such data is critical to improve effectiveness of HIV testing and counselling.

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Youth, Technology, and HIV: Recent Advances and Future Directions.

Lisa Hightow-Weidman, Kathryn E Muessig, Jose Arturo Bauermeister … (2015)

Technology, including mobile technologies and social media, offers powerful tools to reach, engage, and retain youth and young adults in HIV prevention and care interventions both in the USA and globally. In this report, we focus on HIV, technology, and youth, presenting a synthesis of recently published (Jan 2014-May 2015) observational and experimental studies relevant for understanding and intervening on HIV risk, prevention, and care. We present findings from a selection of the 66 relevant citations identified, highlighting studies that demonstrate a novel approach to technology interventions among youth in regard to content, delivery, target population, or public health impact. We discuss current trends globally and in the USA in how youth are using technology, as well as emergent research issues in this field-including the need for new theories for developing technology-based HIV interventions and new metrics of engagement, exposure, and evaluation.

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Author and article information

Contributors

Nicole H.T.M. Dukers-Muijrers: Nicole.dukers@ggdzl.nl

Journal

Journal ID (nlm-ta): Curr HIV/AIDS Rep

Journal ID (iso-abbrev): Curr HIV/AIDS Rep

Title: Current HIV/AIDS Reports

Publisher: Springer US (New York )

ISSN (Print): 1548-3568

ISSN (Electronic): 1548-3576

Publication date (Electronic): 26 February 2025

Publication date PMC-release: 26 February 2025

Publication date (Print): 2025

Volume: 22

Issue: 1

Electronic Location Identifier: 20

Affiliations

[1 ]Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, ( https://ror.org/04af0r679) P.O. Box 33, Heerlen, 6400 AA The Netherlands

[2 ]Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, ( https://ror.org/02jz4aj89) Maastricht, Netherlands

[3 ]Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, ( https://ror.org/02jz4aj89) Maastricht, Netherlands

[4 ]Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+ (MUMC+), ( https://ror.org/02d9ce178) Maastricht, Netherlands

Article

Publisher ID: 724

DOI: 10.1007/s11904-025-00724-5

PMC ID: 11861391

PubMed ID: 40000537

SO-VID: db61146d-4fed-48bd-8363-111bcb2e7638

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 1 February 2025

Funding

Funded by: Aidsfonds Nederland

Award ID: P-49903

Funded by: FundRef https://doi.org/10.13039/501100004528, Maastricht Universitair Medisch Centrum;

Award ID: The Next Step

Custom metadata

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: home-based sexual health care,sti testing,hiv testing,perspective,implementation

Data availability:

ScienceOpen disciplines: Infectious disease & Microbiology

Keywords: home-based sexual health care, sti testing, hiv testing, perspective, implementation

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A Perspective on Home-Based Sexual Health Care: Evidence, Access, and Future Directions

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Abstract

Purpose

Recent Findings

Summary

Related collections

Point-Of-Care Testing for STIs

Most cited references 18

Sex in the Time of COVID-19: Results of an Online Survey of Gay, Bisexual and Other Men Who Have Sex with Men’s Experience of Sex and HIV Prevention During the US COVID-19 Epidemic

Barriers to HIV testing in Europe: a systematic review.

Youth, Technology, and HIV: Recent Advances and Future Directions.

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