Vending machines help Brits self-test for STIs

Vending machines dispensing self-test kits for sexually transmitted infections (STIs) are an effective and acceptable means of reaching people who rarely or never get tested, find the results of a year-long pilot, published in the journal Sexually Transmitted Infections.

They should be considered as part of the digital offer of sexual health services, pending further studies to pinpoint the best locations to ensure privacy and safety, conclude the researchers.

They base their conclusions on a pilot of 11 publicly available vending machines located at seven sites across Brighton and Hove and four in Bristol between April 2022 and March 2023. The machines dispensed rapid HIV tests and self sampling kits for other STIs.

During this time, 2,536 kits were dispensed. And 208 of the users filled in questionnaires about their experience. Self-sample kits for STIs proved the most popular (74% of vends), with most (78%) dispensed to 16- to 35-year-olds.

More than two thirds of users (68%) had not tested for STIs during the past 12 months, and more than half (59%) had never tested. Half the kits (51%) were returned by post, although this is lower than the local online service (65%), note the researchers.

Convenience, instant access, and increased confidentiality were the most common reasons for using a vending machine. Most (92%) respondents thought the machines were user-friendly, and virtually all (97%) would recommend the service. But concerns about safety and privacy were reported by 42% and 66% of respondents, respectively.

In England, in 2022 around half of sexual health service consultations were done face-to-face, but difficulty getting appointments, the time needed for them, the costs of travel, and stigma from health care professionals put people off, say the researchers.

"Machines were valued for their convenience and instant access and could be used for the delivery of other sexual health services, such as contraception and pre-exposure prophylaxis in both higher and lower income settings," they suggest.

But a better understanding of what's required to assure privacy and safety while using the machines along with the feasibility and impact on sexual health service provision is essential, they add.

"Additionally, an economic evaluation is needed to ascertain whether vending machines represent a cost-effective option to reduce the demand on clinics increasing their capacity to provide timely care to individuals with complex needs," they caution.