8th International Conference on HIV Pathogenesis, Treatment and Prevention

1. HIV Self-Testing Increases HIV Testing Frequency
among High Risk MSM: A Randomized Controlled Trial
 230 HIV-negative MSM at high risk for HIV acquisition in Seattle
randomized for 15 months to:
 HIV self-testing (HIVST): access to self-tests at no cost
 Standard Testing: testing as usual
 Aim 1: Compare number of HIV tests during follow-up among men
randomized to HIVST vs. standard testing
 Aim 2: Determine whether HIVST is non-inferior to standard testing
with respect to markers for risk of HIV acquisition
 HIV self-testing = OraQuick on oral fluids, written instructions &
counseling, kits available upon request by mail/pick-up
 All participants recommended to test quarterly & offered
reminders to test per standard of care
David A. Katz, Matthew R. Golden, James P. Hughes, Carey Farquhar, Joanne D. Stekler

2. Access to HIVST increased HIV testing
0%
5%
10%
15%
20%
25%
30%
0 2 4 6 8 10 12 14 16 18 20
Self-reported number of HIV tests during follow-up
Self-testing (N=98)
Control (N=99)
Arm
Number of HIV tests
Mean (95% CI)
≥1 HIV test
N (%)
≥Quarterly testing
N (%)
Self-testing 5.3 (4.7-6.0) 96 (98%) 74 (76%)
Control 3.6 (3.2-4.0) 92 (93%) 53 (54%)
P<0.0001 P=0.17 P=0.001

3. Effect on HIV risk & Conclusions
5%
21%
29%
12%
22%
24%
0%
5%
10%
15%
20%
25%
30%
35%
STI diagnosis
15 months
Non-concordant CAI
9 months
Non-concordant CAI
15 months
Self-testing Control
1 1 1 1
0
1
2
3
Self-testing Control Self-testing Control
Median ( ) and interquartile range ( | ) of male condomless anal
intercourse (CAI) partners reported in last 3 months
9 months 15 months
Risk difference
-6.8% (-16-1.6%)
Odds ratio
1.08 (0.61-1.90)
Incidence rate ratio
0.92 (0.64-1.33)
Conclusions
 HIV self-testing programs may ↑ awareness of HIV status without affecting HIV risk
 Research necessary to:
 Determine effect of self-testing in other settings/populations
 Ensure timely linkage to HIV care
 Identify cost-effective methods for implementation
Poster MOPDC0103; Funded by NIMH (R01 MH086360); Clinicaltrials.gov NCT01161446