Preferred Methods of HIV and Sexually Transmissible Infection Screening Delivery Among a Rural Sample of Men Who Have Sex with Men

Despite the national HIV and sexually transmissible infection (STI) rates growing in rural areas, rural populations-particularly men who have sex with men (MSM), have limited access to secondary (i.e., HIV/STI screening) prevention activities compared with their urban counterparts. We conducted semistructured in-depth interviews with 23 rural MSM residing in Oklahoma and Arkansas to assess their (1) experiences with HIV and STI testing; (2) perceptions of at-home testing; and (3) preferences for receiving results and care. Barriers to accessing HIV/STI screening included lack of medical providers within rural communities, privacy and confidentiality concerns, and perceived stigma from providers and community members. To overcome these barriers, all participants recognized the importance of screening paradigms that facilitated at-home screening, medical consultation, and care. This included the ability to request a testing kit and receive results online, to access affirming and competent providers utilizing telemedicine technology, as well as prompt linkage to treatment. These narratives highlight the need for systems of care that facilitate HIV and STI screening within rural communities, which do not require participants to access services at traditional physical venues.