Home-based sexual health services successfully reach priority populations including previously untested MSM and high-risk individuals, but ensuring equitable care requires research into underserved populations and tailoring of services to address digital access and health literacy barriers.
Home-based sexual health services have successfully reached priority populations, including previously untested men who have sex with men (MSM).
Challenges to clinic-based sexual health care attendance can be overcome by offering lower-threshold home-based sexual health care.
Ensuring equitable care is a key challenge for home-based sexual health services, particularly for individuals with limited digital access or low health literacy.
Continuous monitoring and evaluation of home-based service implementation is recommended to maximize the advantages of this care model.
This perspective paper examines how home-based sexual health services — such as at-home STI and HIV testing kits — affect people's ability to access sexual health care. The researchers found that these services have been effective at reaching groups who are at higher risk for STIs and HIV, including gay and bisexual men (MSM) who had never been tested before. By removing barriers like clinic hours, travel, stigma, and the need to interact in person with healthcare providers, home-based services can bring testing to people who might otherwise go without. However, the paper also highlights an important concern: home-based services are not equally accessible to everyone. People who lack reliable internet access, smartphones, or digital literacy may be left behind by services that rely heavily on online platforms or apps. Similarly, individuals with low health literacy may struggle to navigate self-testing processes or understand their results. These gaps mean that while home-based care helps many, it could inadvertently widen health inequalities for the most vulnerable groups. This research suggests that home-based sexual health services are a valuable and promising addition to traditional clinic-based care, but they should not be seen as a one-size-fits-all solution. To make these services truly equitable, ongoing research is needed to understand what underserved populations need, and services should be tailored accordingly. Regular monitoring of how well these programs are working — and for whom — will be essential to ensure no one is left behind.
Hanneke Goense C, Evers Y, Hoebe C, Dukers-Muijrers N. (2025). A Perspective on Home-Based Sexual Health Care: Evidence, Access, and Future Directions.. Current HIV/AIDS reports. https://doi.org/10.1007/s11904-025-00724-5