Self reported acceptance and preference for home based HIV testing among heterosexuals living in high risk areas

Background

It has been estimated that one-fifth of persons infected with HIV in the United States are unaware of their status. Unfortunately stigma surrounding HIV testing still persists for clinic or community-based testing in many populations. Recently self-administered and/or home based HIV testing (HBT) options have been approved for use in the U.S., which may hold the promise to reduce these barriers.

Methods

The current study measures acceptance and preference towards HBT in a sample of 531 heterosexuals surveyed through the New Orleans arm of the National HIV Behavioral Surveillance system during late 2013. All participants were asked an additional set of locally developed questions surrounding HBT.

Results

Of those surveyed, 83% responded that they would take a free HBT if it was mailed to them as part of a research study or by a health department. While virtually all (99%) indicated that they would seek care based on a reactive result, 54% indicated that they would report that result back to the provider agency. Reasons for not wanting to take the test included perceptions of low HIV risk and distrust of results.  Never having been tested for HIV as well as gender, homelessness, income and neighborhood dysfunction were predictors of HBT acceptance.

Discussion

Universal testing is one of the cornerstones to the “Treatment as Prevention” approach to HIV elimination. Because high rates of heterosexual acceptance of HBT were found, especially among those reporting never being tested, HBT should be considered for addition to existing community based testing programs.