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At-home HIV testing of MSM enrolled in an online HIV behavioral risk study
 

At-home HIV testing of MSM enrolled in an online HIV behavioral risk study

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    At-home HIV testing of MSM enrolled in an online HIV behavioral risk study At-home HIV testing of MSM enrolled in an online HIV behavioral risk study Presentation Transcript

    • Christine Khosropour, MPH Rollins School of Public Health Emory University August 15, 20112011 National HIV Prevention Conference Atlanta, GA
    •  Underrepresentation of black and Hispanic study participants Lack of biological outcomes on study participants Inability to retain participants for a period sufficient to assess outcome measures  High attrition of black and Hispanic MSM
    •  Underrepresentation of black and Hispanic study participants Lack of biological outcomes on study participants Inability to retain participants for a period sufficient to assess outcome measures  High attrition of black and Hispanic MSM
    • Sharma et al, JIAPAC, 2011
    •  Enrolled white, black, and Hispanic MSM in an online 12-month longitudinal study  > 18 years old  Had a male sex partner in past 12 months  Willing to complete an at-home HIV test  Had an SMS-enabled mobile phone
    •  Enrolled white, black, and Hispanic MSM in an online 12-month longitudinal study  > 18 years old  Had a male sex partner in past 12 months  Willing to complete an at-home HIV test  Had an SMS-enabled mobile phone
    • Bi-monthly FU Online FU Baseline Month 12 Black Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV TestClick-through banner ad Bi-monthly FU Online FU Baseline Month 12 Screening Consent White Online Online Questions Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test Bi-monthly FU Online FU Baseline Month 12 Hispanic Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test
    • Bi-monthly FU Online FU Baseline Month 12 Black Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV TestClick-through banner ad Bi-monthly FU Online FU Baseline Month 12 Screening Consent White Online Online Questions Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test Bi-monthly FU Online FU Baseline Month 12 Hispanic Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test
    • Willing to take Not willing to take home HIV test home HIV test Crude Odds Ratio n (%) n (%)Race/Ethnicity (95% CI)White, non-Hispanic 3,126 (48) 3,442 (52) ReferentBlack, non-Hispanic 2,977 (60) 1,963 (40) 1.67 (1.55 – 1.80)Hispanic 1,445 (59) 1,023 (41) 1.56 (1.42 – 1.71) Total 7,548 (54) 6,428 (46)
    • Bi-monthly FU Online FU Baseline Month 12 Black Online Online Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV TestClick-through banner ad Bi-monthly FU Online FU Baseline Month 12 Screening Consent White Online Online Questions Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV TestSelf-report: • HIV negative Online FU Bi-monthly FU • Unknown Hispanic Baseline Month 12 Online Online • Never tested Survey Survey Bi-monthly FU Baseline SMS FU Month 12 HIV Test HIV Test
    •  Secure data transfer Results over the phone  HIV+ automatically linked to a counselor FDA approved call center  Access to local resources  Only FDA-approved telemedicine HIV counseling and testing service in US
    • 896 HIV test kits sent17.5% 157 62.9% 564 19.5% 175 Black White Hispanic
    •  Choice of reminder modality  Phone call  Text message  Email Personal outreach  Phone call to participant
    • 896 82% 735Test kits sent Test kits returned 564 85% 481 White White 157 73% 115 Black Black 175 79% 139 Hispanic Hispanic
    • 735 3.4% 25Test kits returned HIV + 481 2.3% 11 White White 115 7.8% 9 Black Black 139 3.6% 5 Hispanic Hispanic
    • 25 HIV+ • 11 White • 9 Black • 5 Hispanic 11 Did not continue study 14 Active FU • 7 White • 5 Black • 2 Hispanic2 Not Linked 12 Linked to Care 12 Received • 7 White • 3 Black Counseling • 2 Hispanic
    •  Willingness to take home HIV test 82% HIV at-home test kit return  Biological outcome = estimated HIV incidence  Difference in kit return by race/ethnicity  Personal outreach to increase kit return 3.4% HIV+ among self-reported non-positive  Known linkage to care = 86% among respondents
    •  Research participants Patrick Sullivan, DVM, PhD Alexandra Ricca, MPH Sullivan Research Team Cyclogram Emory Center for AIDS Research (CFAR)  P30 AI050409 NIH, National Center on Minority Health and Health Disparities  Grant # RC1MD004370