To directly support the federal Ending the HIV Epidemic (EHE) initiative and accelerate the identification of undiagnosed infections in the US, CDC implemented a program aimed to mail 100,000 HIV self-tests to prioritized populations at-risk for HIV through paid advertising, social media, and partner outreach.
CDC directed a marketing campaign to reach Black/African American and Hispanic/Latino gay men, transgender women, and Black/African American women living in areas of the US identified by the EHE initiative as having high HIV burden. Campaign messages included a weblink for a CDC-supported online ordering portal. Persons 17 years or older and living in the US or Puerto Rico could place an order for 1 or 2 HIV self-tests. Persons with HIV infection or taking pre-exposure prophylaxis (PrEP) were encouraged to share the test and not use it themselves. After placing an order, participants were invited to complete a short non-incentivized survey.
The ordering portal was live for eight months (February 3, 2021-October 11, 2021). During this period, 56,458 persons placed an order. Three-fourths of participants (74.5%) ordered 2 HIV self-tests. Over half of the orders (55%) were placed from EHE locations, although orders were placed from all US states and Puerto Rico (Figure). The survey response rate was 82.2%. One-fourth of participants (26%) reported no prior HIV testing, while another 33% indicated that they were last tested for HIV more than a year ago. Some reported taking PrEP (4.9%) or testing positive for HIV prior to ordering (1.6%). Over a third of participants (36.7%) were non-Hispanic (NH) White persons, while 26.8% were Hispanic persons, and 24.8% were NH Black persons. Most participants (69.4%) identified as men, 26% as women, and 4.6% identified as another gender, including 1.4% transgender women. Most male participants (69%) reported having anal sex with a man in the past 12 months. Of the men who had sex with men, 17.0% were NH Black and 35% were Hispanic. Among women, 42.7% were NH Black, 29.7% NH White, and 19.3% were Hispanic.
CDC’s first direct-to-consumer distribution of HIV self-tests resulted in 100,000 HIV self-tests being distributed in 8 months. This program highlights the demand for HIV self-tests, even reaching persons who never were tested for HIV. Clinicians, community-based organizations, and testing clinics should be aware that persons with preliminary positive HIV self-test results will require further testing and care.