Abstract Body

The home HIV test may increase HIV status awareness. Advantages include convenience and privacy; barriers include cost and limited access. New York City (NYC) Health Department distributed HIV self-tests (HIVST) to men and transgender people who have sex with men (MTSM) at no charge by mail. We examined the feasibility and reach of our HIVST Giveaway (HTG) model.

Participants were recruited on dating applications and websites. Eligibility was limited to adult NYC residents who were MTSM and not previously HIV-diagnosed. Eligible participants were emailed a code to redeem on the manufacturer’s website for a HIVST. Data collected via online eligibility survey included age, race/ethnicity, and time since last HIV test. Approximately 2 months after distribution ended, an online follow-up survey was used to collect information on test receipt, use, experience, result and, if appropriate, confirmatory testing. Sociodemographic factors and behaviors related to risk of HIV exposure were also assessed. To examine representativeness of those who followed up, we compared eligibility survey responses of all code redeemers to test receivers (reported on follow-up) (Chi-square test).

Recruitment concluded in 23 days with 2500 codes distributed. Among those screened, 74% were deemed eligible (Table). Among eligible participants, 71% were code redeemers. Response to the follow-up survey was 48%. Among respondents, 74% of test receivers had used the test. Most test users (72%) were <35 year-old, 41% were of color, 18% had income <$20,000/year, 86% reported risk of HIV exposure (past 6 months), and 14% and 28% reported never testing and testing >1 year prior, respectively. Most test users (71%) reported testing sooner than usual or for the first time and 98% reported being likely to recommend HTG to a friend. Among 868 test users, 7 reported a reactive result (0.8%), of whom 5 reported no previous diagnosis; among the latter, 80% (4/5) reported receiving a confirmatory test. No differences were detected comparing all code redeemers to test receivers (p<0.05).

The HTG rapidly distributed a large volume of tests to a diverse set of NYC MTSM, many of whom had never tested or not tested recently. Despite reaching those at higher risk of HIV exposure, reported seropositivity was relatively low. Findings have motivated future HTG adaptions, including partnership with community-based organizations to recruit those at risk of HIV exposure who may not be reached online.