Mailing Free HIV Tests to Homes Seems a Better Approach to Detection Than Usual Care

Researchers with the US Centers for Disease Control and Prevention and Emory University recruited about 2,600 high-risk men to see if mailing them free HIV test kits might be a better method of detection than usual care. That seems to be the case, according to an original investigation published today in JAMA Internal Medicine. “Distribution of HIV self-tests provides a worthwhile mechanism to increase awareness of HIV infection and prevent transmission among” men who have sex with other men, investigators concluded.

Study participants were recruited through advertisements on social media, dating and music websites from March through August 2015. Participants included men in the United States who had anal sex in the last year and were either HIV-negative or not aware of their HIV status. They created an online account through which investigators could contact them. The self-test group comprised 1,325 men; the control group 1,340.

The men received $90 for completing surveys at the beginning and then at 3, 6, 9, and 12 months, and reported self-test results at 12 months. “Telephone call notes and laboratory test results were included in the analysis, which was completed from August 2017 through December 2018,” the study stated.

Men in the intervention group were mailed two oral fluid HIV self-tests and two finger-stick whole blood HIV self-tests. The control group got a link to local testing services for standard care.

The self-testing participants tested 3 or more times during the trial than the control group, 76.7% v. 22%. In addition, 25 infections were detected in the self-testing group, versus 11 in the control group. In addition, “The [self-test] participants reported 34 newly identified infections among social network members who used the self-tests,” the study stated.

About 1 million Americans have HIV, the virus that causes AIDS. More than two-thirds of newly diagnosed people are men who have sex with men; 1 in 6 of these men is unaware of his infection.

Robin MacGowan, the lead author and a CDC researcher, said that “self-testing is an important option for some people and in some situations, it saves time, offers privacy, and reaches people who may not be able to or willing to access existing testing services.”