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Comparison of Home-Based Oral Fluid Rapid HIV Self-Testing Versus Mail-in Blood Sample Collection or Medical/Community HIV Testing By Young Adult Black, Hispanic, and White MSM: Results from a Randomized Trial

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Abstract

We aimed to determine in a randomized trial if young adult black, Hispanic, and white men-who-have-sex-with-men (YMSM) are more likely to complete home-based oral fluid rapid HIV self-testing than either mail-in blood sample collection or medical facility/community organization-based HIV testing. Stratified by race/ethnicity, participants were randomly assigned to use a free oral fluid rapid HIV self-test (n = 142), a free mail-in blood sample collection HIV test (n = 142), or be tested at a medical facility/community organization of their choice (n = 141). Of the 425 participants, completion of assigned test (66% oral fluid vs. 40% mail-in blood sample vs. 56% medical facility/community), willingness to refer (36% oral fluid vs. 20% mail-in blood sample vs. 26% medical facility/community), and legitimate referrals (58% oral fluid vs. 43% mail-in blood sample vs. 43% medical facility/community) were greater in the oral fluid rapid HIV self-test than the mail-in blood sample collection HIV test arm, but not the medical facility/community testing arm. There were no differences in assigned test completion by race/ethnicity. Although free home-based oral fluid rapid HIV self-testing showed moderate promise in facilitating HIV testing among black, Hispanic, and white YMSM, it did not lead to greater testing than directing these YMSM to medical facility/community HIV testing venues. ClinicalTrials.gov Identifier: NCT02369627.

Resumen

El objetivo de este ensayo aleatorio fue determinar si hombres jóvenes negros, hispanos, y blancos que tienen sexo con otros hombres (siglas en inglés YMSM) son más probables de completar una prueba rápida casera de autoexamen para el VIH con fluidos orales que una prueba del VIH en que se envíe una muestra de sangre por correo o una prueba de VIH que se hace en un centro médico/organización comunitaria. Estratificados por raza/etnicidad, los participantes fueron asignados aleatoriamente a usar una prueba oral rápida casera de autoexamen gratuita para el VIH (n = 142), una prueba gratuita del VIH en que se envíe una muestra de sangre por correo (n = 142), o hacerse la prueba del VIH en un centro médico/organización comunitaria de su preferencia (n = 141). De los 425 participantes, la realización de la prueba asignada (66% con fluidos orales vs. 40% muestra de sangre enviada por correo vs. 56% hecha en un centro médico/comunitario), disposición a referir (36% con fluidos orales vs. 20% muestra de sangre enviada por correo vs. 25% hecha en un centro médico/comunitario), y referencias legitimas (58% con fluidos orales vs. 43% muestra de sangre enviada por correo vs. 43% hecha en un centro médico/comunitario) fue mayor en el grupo de la prueba rápida de autoexamen para el VIH con fluidos orales que en el grupo de la prueba del VIH en que se envíe una muestra de sangre por correo, pero no mayor que en el grupo que fue a un centro médico/comunitario. No hubo diferencias en la realización de la prueba asignada por raza/etnicidad. A pesar de que la prueba casera con fluidos orales demostró ser moderadamente promisoria en facilitar pruebas del VIH entre negros, hispanos y blancos YMSM, no condujo a más realización de pruebas que dirigiendo a estos YMSM a un centro médico/comunitario donde se hacen pruebas del VIH.

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Funding

This study was funded by the National Institute of Nursing Research (R21 NR023869).

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Authors and Affiliations

  1. Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, USA

    Roland C. Merchant

  2. Department of Epidemiology, School of Public Health, Brown University, Providence, USA

    Roland C. Merchant

  3. Department of Quantitative Health Sciences and Center for Health Policy and Research, University of Massachusetts Medical School, Worcester, USA

    Melissa A. Clark

  4. Department of Biostatistics, Center for Statistical Sciences, School of Public Health, Brown University, Providence, USA

    Tao Liu & Justin Romanoff

  5. Department of Biobehavioral Health, Pennsylvania State University, State College, USA

    Joshua G. Rosenberger

  6. Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, USA

    Jose Bauermeister

  7. Fenway Health, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, USA

    Kenneth H. Mayer

  8. Department of Emergency Medicine, Rhode Island Hospital, 593 Eddy Street, Claverick Bldg., Providence, RI, 02903, USA

    Roland C. Merchant

Authors
  1. Roland C. Merchant
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  2. Melissa A. Clark
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  3. Tao Liu
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  4. Justin Romanoff
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  5. Joshua G. Rosenberger
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  6. Jose Bauermeister
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  7. Kenneth H. Mayer
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Corresponding author

Correspondence to Roland C. Merchant.

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Conflict of interest

Dr. Rosenberger previously was a consultant for Online Buddies, Inc. Dr. Mayer has received unrestricted research grants from Gilead Sciences and ViiV Healthcare. Drs. Bauermeister, Clark, Liu, and Merchant declare no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All participants provided consent to be in the study.

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Merchant, R.C., Clark, M.A., Liu, T. et al. Comparison of Home-Based Oral Fluid Rapid HIV Self-Testing Versus Mail-in Blood Sample Collection or Medical/Community HIV Testing By Young Adult Black, Hispanic, and White MSM: Results from a Randomized Trial. AIDS Behav 22, 337–346 (2018). https://doi.org/10.1007/s10461-017-1802-x

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  • DOI: https://doi.org/10.1007/s10461-017-1802-x

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