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In addition, those willing to use HIVST are also willing to use PrEP. Personalized virtual counseling could be crucial among this population. Efforts to increase HIVST knowledge and resolve perceived barriers are warranted, especially among MSM with lower income and education from Brazil, Mexico, and Peru. In general, willingness to use HIVST was associated with higher income (aPR range: 1.49 to 1.97), higher education (aPR range: 1.13 to 1.42), and willingness to use PrEP (aPR range: 1.19 to 1.72). Having the knowledge to deal with a positive HIVST resulted in increased willingness to use HIVST (aPR range: 1.11 to 1.22), while a lack of trust in HIVST compared to HIV testing in clinics was inversely associated (aPR range: 0.80 to 0.90). Most participants think post-test counseling is essential and that dealing with a positive result would be difficult (aPR 1.13 to 1.37, range of aPRs across the three countries). Across the countries, the patterns of association of willingness with HIVST barriers were similar. Awareness and willingness to use HIVST were higher in Brazil than in Peru and Mexico (p <.
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Overall, 20% of MSM had never tested for HIV. A total of 18,916 completed the survey, 59% from Brazil, 30% from Mexico, and 11% from Peru. We used multivariable Poisson regression models to calculate adjusted prevalence ratios (aPR) to assess the factors associated with willingness to use HIVST for each country. We included cisgender men ≥18 years old who self-reported HIV-negative status. A cross-sectional web-based survey was advertised in two geosocial networking apps (Grindr and Hornet) and Facebook in 2018. This study describes awareness, willingness, and barriers to HIVST among MSM in Brazil, Mexico, and Peru. However, HIVST use among key populations remains low. HIV self-testing (HIVST) is an essential tool within the combined HIV prevention package and has been available in Latin America since 2015.