HIV Self-Tests Reached High-Risk Populations

Direct-to-consumer HIV self-testing helped to reach underserved populations in areas at high risk for HIV infection, a researcher said.

In an ordering portal set up by the CDC, over 56,000 people placed an order for HIV self-tests, and according to a follow-up survey, about a quarter (26%) of those had never been tested for HIV, reported Pollyanna Chavez, PhD, of the CDC.

Moreover, a third of those who ordered a self-test and responded to the survey said they hadn’t been tested for HIV in over a year.

“We estimate about one in eight people with HIV do not know they have it,” Chavez said at a press conference at the virtual Conference on Retroviruses and Opportunistic Infections (CROI). “One of the goals of ending the HIV epidemic … is to diagnose people as early as possible [and] HIV self-testing is a key innovation being used in pursuit of this goal.”

CDC designed marketing campaigns to reach Black and Hispanic gay and bisexual men, cisgender Black women, and transgender women in areas identified as having a high burden of HIV.

These materials included a link to an online ordering portal, where individuals ages 17 and up in the 50 U.S. states, Washington D.C., and Puerto Rico could order one or two HIV self-tests, and then were invited to participate in a follow-up survey afterwards.

Chavez noted that the program was designed to support the federal Ending the HIV Epidemic efforts by increasing outreach to prioritized populations and mailing up to 100,000 HIV self-tests on request.

The online portal was open from February 3 to October 11, 2021. Of the 56,458 people who placed an order, three-quarters ordered two HIV self-tests (vs one), and 55% of the orders were placed from priority locations. About 82% of patients also responded to the follow-up survey.

In the survey, 37% of participants were non-Hispanic white, while 25% were non-Hispanic Black and 27% were Hispanic. About 70% were men, 26% were women, and 4.6% identified as another gender, including 1.4% who were transgender women.

Around 70% of men reported having sex with men (MSM) in the last year, and of those, 43% were non-Hispanic Black and 35% were Hispanic. About 43% of women were non-Hispanic Black, 30% were non-Hispanic white, and 19% were Hispanic.

“It’s really fantastic to see the uptake of tests and responsiveness to the survey,” said CROI Chair Elaine Abrams, MD, of Columbia University Irving Medical Center in New York City, who moderated the press conference, but was not involved with the research.

Abrams asked Chavez if CDC had any data on how many of those who tested positive were linked to care, but Chavez said that information was not available “at the moment.”

“Our main objective was to understand if there was demand … and if we could reach priority populations with HIV self-tests,” she said.

Likewise, there were no data on how many of those who ordered a self-test ultimately tested positive.

“HIV self-tests filled the need for testing during the COVID pandemic,” Chavez said. “We should consider self-testing one of the many tools in our toolbox to be able to address and achieve the goals” of ending the HIV epidemic in the U.S.