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Coming out in rural areas is “absolutely impossible” , said Elena Birindzhieva from the LGBT health centre Check Point Sofia.

“There can be physical violence, there can be verbal aggression,” she said.

People who are unaware they have HIV are more likely to have unprotected sex, risking the spread of infection further, found a 2014 study in Mozambique.

Although HIV tests are anonymous, patients in Bulgaria were often required to identify themselves when they entered a health centre and reveal where they were going, said Momchil Baev, the sexual health programme manager at Single Step.

Almost one in three said they had never been tested for HIV before, and a further quarter had not checked their status in more than a year.

A total of 900 people ordered tests and 332 people reported their results back to Single Step, of whom ten tested positive and were diagnosed with HIV.

HIV testing vans used in rural areas were also highly visible and associated with stigma, he said.

The consequences of being outed could be devastating, especially outside the biggest cities, said gay men and LGBT health experts.

“It’s not just this one little pilot project - I really think it can have wider impact,” said Dimov.Grindr has stressed the data was only used to test new features and was never sold or available to advertisers.Taskov also raised concerns over cost, saying the self-tests were considerably more expensive than a standard blood test.“I am very proud of this campaign because we really designed it to address a problem,” said Dimov.

“Together we designed something very pragmatic.” The project was among a handful experimenting with HIV self-testing aimed at LGBT people.

“I came out at age 17 and my mother took me to a psychiatrist to try to ‘mend’ me,” said one gay man living in Sofia, who asked not to be identified.


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