Internet-guided HCV-RNA testing: A promising tool to achieve hepatitis C micro-elimination among men who have sex with men.

In the Netherlands, hepatitis C virus (HCV) transmission occurs primarily in men who have sex with men (MSM). By early diagnosis and immediate treatment of acute HCV infections, HCV micro-elimination in MSM is within reach. In cooperation with the community affected, we developed an online HCV-RNA home-based self-sampling test service. This service combined online HCV self-risk assessment with the possibility to test anonymously for HCV-RNA. The service was available in the Netherlands from February 2018 till December 2020 and was promoted online on various dating sites and offline by community volunteers. Using website user data, test results and an online post-test user survey, we evaluated the service and user experiences. The website page with information about testing was visited by 3401 unique users, of whom 2250 used the HCV-risk assessment tool, 152 individuals purchased 194 HCV-RNA tests, and 104 tests were used, of which 101 gave a conclusive result. The target population of MSM at risk was successfully reached with 44.1% of users receiving the advice to test. The test service had a satisfactory uptake (6.8%, 152/2250), a very high HCV-RNA positivity rate (10.9%, 11/101) and was considered acceptable and easy to use by most MSM. We demonstrate that an HCV-RNA home-based self-sampling test service is successful in diagnosing HCV infections among MSM. This service could be a valuable addition to existing sexual healthcare services as it may reach men who are otherwise not tested.