Christine Khosropour, MPH     Rollins School of Public Health            Emory University            August 15, 20112011 N...
   Underrepresentation of black and Hispanic    study participants   Lack of biological outcomes on study    participant...
   Underrepresentation of black and Hispanic    study participants   Lack of biological outcomes on study    participant...
Sharma et al, JIAPAC, 2011
   Enrolled white, black, and Hispanic MSM in an    online 12-month longitudinal study     > 18 years old     Had a mal...
   Enrolled white, black, and Hispanic MSM in an    online 12-month longitudinal study     > 18 years old     Had a mal...
Bi-monthly FU                                                    Online FU                                         Baselin...
Bi-monthly FU                                                    Online FU                                         Baselin...
Willing to take   Not willing to take                         home HIV test      home HIV test                            ...
Bi-monthly FU                                                    Online FU                                         Baselin...
   Secure data transfer   Results over the phone     HIV+ automatically linked to a     counselor   FDA approved call ...
896                  HIV test kits sent17.5%        157     62.9%   564       19.5%                                       ...
   Choice of reminder modality     Phone call     Text message     Email   Personal outreach     Phone call to parti...
896          82%         735Test kits sent         Test kits returned    564          85%          481    White           ...
735            3.4%     25Test kits returned           HIV +       481           2.3%     11      White                  W...
25 HIV+                     • 11 White                     • 9 Black                     • 5 Hispanic                     ...
   Willingness to take home HIV test   82% HIV at-home test kit return     Biological outcome = estimated HIV incidence...
   Research participants   Patrick Sullivan, DVM, PhD   Alexandra Ricca, MPH   Sullivan Research Team   Cyclogram   ...
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
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
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
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

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

  1. 1. Christine Khosropour, MPH Rollins School of Public Health Emory University August 15, 20112011 National HIV Prevention Conference Atlanta, GA
  2. 2.  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
  3. 3.  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
  4. 4. Sharma et al, JIAPAC, 2011
  5. 5.  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
  6. 6.  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
  7. 7. 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
  8. 8. 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
  9. 9. 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)
  10. 10. 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
  11. 11.  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
  12. 12. 896 HIV test kits sent17.5% 157 62.9% 564 19.5% 175 Black White Hispanic
  13. 13.  Choice of reminder modality  Phone call  Text message  Email Personal outreach  Phone call to participant
  14. 14. 896 82% 735Test kits sent Test kits returned 564 85% 481 White White 157 73% 115 Black Black 175 79% 139 Hispanic Hispanic
  15. 15. 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
  16. 16. 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
  17. 17.  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
  18. 18.  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

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