Usage of purchased self-tests for HIV and sexually transmitted infections in Amsterdam, the Netherlands: results of population-based and serial cross-sectional studies among the general population and sexual risk groups

BMJ Open. 2017 Sep 21;7(9):e016609. doi: 10.1136/bmjopen-2017-016609.


Objectives: There are limited data on the usage of commercially bought self-tests for HIV and other sexually transmitted infections (STIs). Therefore, we studied HIV/STI self-test usage and its determinants among the general population and sexual risk groups between 2007 and 2015 in Amsterdam, the Netherlands.

Setting: Data were collected in four different studies among the general population (S1-2) and sexual risk groups (S3-4).

Participants: S1-Amsterdam residents participating in representative population-based surveys (2008 and 2012; n=6044) drawn from the municipality register; S2-Participants of a population-based study stratified by ethnicity drawn from the municipality register of Amsterdam (2011-2015; n=17 603); S3-Men having sex with men (MSM) participating in an HIV observational cohort study (2008 and 2013; n=597) and S4-STI clinic clients participating in a cross-sectional survey (2007-2012; n=5655).

Primary and secondary outcome measures: Prevalence of HIV/STI self-test usage and its determinants.

Results: The prevalence of HIV/STI self-test usage in the preceding 6-12 months varied between 1% and 2% across studies. Chlamydia self-tests were most commonly used, except among MSM in S3. Chlamydia and syphilis self-test usage increased over time among the representative sample of Amsterdam residents (S1) and chlamydia self-test usage increased over time among STI clinic clients (S4). Self-test usage was associated with African Surinamese or Ghanaian ethnic origin (S2), being woman or MSM (S1 and 4) and having had a higher number of sexual partners (S1-2). Among those in the general population who tested for HIV/STI in the preceding 12 months, 5-9% used a self-test.

Conclusions: Despite low HIV/STI self-test usage, we observed increases over time in chlamydia and syphilis self-test usage. Furthermore, self-test usage was higher among high-risk individuals in the general population. It is important to continue monitoring self-test usage and informing the public about the unknown quality of available self-tests in the Netherlands and about the pros and cons of self-testing.

Keywords: Chlamydia; Public Health; Self-testing; Syphilis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • Humans
  • Logistic Models
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Netherlands / epidemiology
  • Reagent Kits, Diagnostic / statistics & numerical data*
  • Risk Factors
  • Self Care*
  • Sexual Behavior
  • Syphilis / diagnosis*
  • Syphilis / epidemiology
  • Young Adult


  • Reagent Kits, Diagnostic