Acceptability, usability, and user experiences of an online postal self-sampling approach for HIV and STI testing in Belgium: Test2Know

BackgroundOnline postal self-sampling (OPSS) for HIV/STI improves testing access and coverage. We assessed the acceptability, usability, and user experiences of the "Test2Know" (T2K) OPSS platform in Flanders, Belgium, to inform further implementation.MethodsEligible users completed a risk-assessment to determine infections (HIV, syphilis, chlamydia, gonorrhoea, hepatitis C) and anatomical sites for testing. Self-collected samples were mailed to the laboratory, and results were communicated via the platform. Users completed surveys on acceptability, usability and overall user experience.ResultsOf 131 individuals who received a kit; 98 (74.8%) returned samples. 62.2% were male, 27.6% were men who had exclusively sex with men, and the median age was 29 years. Nearly 43% had never been tested for HIV or did not recall previous testing. 9 (9.2%) tested positive for an STI, all men; 7/9 reported sex exclusively with men, and 2/9 had never tested for HIV. No HIV or HCV infections were detected. Usability and acceptability were 89.2% and 83.3% respectively, nearly 90% would reuse and recommend the platform. However, 45.4% preferred a mixed testing approach due to blood collection challenges.ConclusionsOPSS is highly acceptable and reaches individuals at risk for STI. Further research should explore sustainable integration into Belgian healthcare.