AIDS and Behavior

, Volume 20, Issue 9, pp 2000–2009 | Cite as

Information, Motivation, and Behavioral Skills of High-Risk Young Adults to Use the HIV Self-Test

  • William BrownIII
  • Alex Carballo-Diéguez
  • Rita Marie John
  • Rebecca SchnallEmail author
Original Paper


HIV self tests (HIVST) have the potential to increase testing among young adults. However, little is known about high-risk young adults’ perception of the HIVST as a risk reduction tool and how they would use the HIVST in their everyday lives. Our study sought to examine these factors. Twenty-one ethnically diverse participants (ages 18–24) used the HIVST at our study site, completed surveys, and underwent an in-depth interview. Descriptive statistics were used to analyze the survey responses, and interview data were coded using constructs from the information-motivation-behavioral skills model. Information deficits included: how to use the HIVST and the “window period” for sero-conversion. Motivations supporting HIVST use included: not needing to visit the clinic, fast results, easy access, and use in non-monogamous relationships. Behavioral skills discussed included: coping with a positive test, handling partner violence after a positive test, and accessing HIV services. These findings can inform the use of the HIVST for improving HIV testing rates and reducing HIV risk behavior.


HIV self tests Prevention Information–motivation–behavioral skills (IMB) IMB model High-risk Youth 


El autoexamen para el VIH (prueba casera conocida como HIVST por sus siglas en inglés) tiene el potencial de aumentar las pruebas de VIH entre los adultos jóvenes. Sin embargo, poco se conoce con respecto a la percepción de los adultos jóvenes de alto riesgo acerca de esta prueba como herramienta para reducir el riesgo y de cómo utilizarla en su vida cotidiana. Nuestro estudio trató de examinar estos factores. Veintiún participantes de diversos grupos étnicos (edades 18–24) utilizaron esta prueba (HIVST) en nuestro sitio de estudio, completaron encuestas, y se les realizó una entrevista en profundidad. Las respuestas de la encuestas fueron analizadas a través de estadística descriptiva y los datos de la entrevista fueron codificados utilizando constructos del Modelo de Habilidades de Información-Motivación-Conductual. El déficit de información incluyó: cómo utilizar la prueba HIVST, y el “Período de Ventana” para la seroconversión. Las motivaciones a favor del uso del HIVST incluyen: No tener que visitar la clínica, resultados rápidos, fácil acceso, y su uso en las relaciones no-monógamas. Las habilidades conductuales que se trataron incluyeron: hacer frente a un resultado positivo, enfrentarse a una reacción violenta de la pareja ante un resultado positivo, y el acceso a los servicios de VIH. Estos hallazgos pueden informar el uso del HIVST para mejorar las tasas de pruebas del VIH y reducir las conductas de riesgo de VIH.

Palabras clave

Prueba casera de autoexámen para el VIH (HIVST) Prevención Habilidades de Información-Motivación-Conductual (IMB) modelo IMB Alto Riesgo Juventud 


  1. 1.
    Centers for Disease C, Prevention. Vital signs: HIV infection, testing, and risk behaviors among youths—United States. MMWR Morb Mortal Wkly Rep. 2012;61(47):971–6.Google Scholar
  2. 2.
    Center for Disease Control and Prevention (CDC). CDC—HIV Among Youth—Age—Risk—HIV/AIDS 2012 [cited 2015 October 12].
  3. 3.
    Center for Disease Control and Prevention (CDC). HIV among African American Youth 2014. Accessed 11 Sep 2015
  4. 4.
    Center for Disease Control and Prevention (CDC). HIV among Latinos fact sheet. 2011.Google Scholar
  5. 5.
    Center for Disease Control and Prevention (CDC). HIV Testing in the United States Atlanta, GA2015. Accessed 13 Oct 2015
  6. 6.
    Kann L, Kinchen S, Shanklin SL, Flint KH, Kawkins J, Harris WA, et al. Youth risk behavior surveillance—United States, 2013. MMWR Surveill Summ. 2014;63(Suppl 4):1–168.Google Scholar
  7. 7.
    Wejnert C, Le B, Rose CE, Oster AM, Smith AJ, Zhu J, et al. HIV infection and awareness among men who have sex with men—20 cities, United States, 2008 and 2011. PLoS ONE. 2013;8(10):e76878.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Cooley LA, Wejnert C, Rose CE, Paz-Bailey G. Increases in recent HIV testing among men who have sex with men coincide with the Centers for Disease Control and Prevention’s Expanded Testing Initiative. Clin Infect Dis. 2015;60(3):483–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Philbin MM, Tanner AE, DuVal A, Ellen J, Kapogiannis B, Fortenberry JD. Linking HIV-positive adolescents to care in 15 different clinics across the United States: creating solutions to address structural barriers for linkage to care. AIDS Care. 2014;26(1):12–9. doi: 10.1080/09540121.2013.808730.CrossRefPubMedGoogle Scholar
  10. 10.
    Balán IC, Carballo-Diéguez A, Frasca T, Dolezal C, Ibitoye M. The impact of rapid HIV home test use with sexual partners on subsequent sexual behavior among men who have sex with men. AIDS Behav. 2014;18(2):254–62.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Ibitoye M, Frasca T, Giguere R, Carballo-Diéguez A. Home testing past, present and future: lessons learned and implications for HIV home tests. AIDS Behav. 2014;18(5):933–49.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Orasure Technologies. OraQuick® advance rapid HIV-1/2 antibody test customer letter. OraSure Technologies. Bethlehem, PA 2005Google Scholar
  13. 13.
    Schnall R, Carballo-Diéguez A, Larson E. Can the HIV home test promote access to care? lessons learned from the in-home pregnancy test. AIDS Behav. 2014;18(12):2496–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Kiene SM, Fisher WA, Shuper PA, Cornman DH, Christie S, MacDonald S, et al. Understanding HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy: an information—motivation—behavioral skills model analysis. Health Psychol. 2013;32(8):860–8.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Ferrer RA, Morrow KM, Fisher WA, Fisher JD. Toward an information–motivation–behavioral skills model of microbicide adherence in clinical trials. AIDS Care. 2010;22(8):997–1005.CrossRefPubMedGoogle Scholar
  16. 16.
    Fisher JD, Fisher WA, Bryan AD, Misovich SJ. Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychol. 2002;21(2):177–86.CrossRefPubMedGoogle Scholar
  17. 17.
    Carey MP, Schroder KE. Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Educ Prev. 2002;14(2):172–82.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Ventuneac A, Carballo-Diéguez A. HIV home test information; 2008. Unpublished (in press)Google Scholar
  19. 19.
    Urberg KA, Shiang-Jeou S, Liang J. Peer influence in adolescent cigarette smoking. Addict Behav. 1990;15(3):247–55.CrossRefPubMedGoogle Scholar
  20. 20.
    Robertson AA, Stein JA, Baird-Thomas C. Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the information-motivation-behavior skills (IMB) model. J Adolesc Health. 2006;38(1):18–25.CrossRefPubMedGoogle Scholar
  21. 21.
    Carballo-Diéguez A, Ventuneac A. Intention to use HIV home test; 2007. Unpublished (in press)Google Scholar
  22. 22.
    Catania JA, Kegeles SM, Coates TJ. Towards an understanding of risk behavior: an AIDS risk reduction model (ARRM). Health Educ Q. 1990;17(1):53–72.CrossRefPubMedGoogle Scholar
  23. 23.
    Boshamer CB, Bruce KE. A scale to measure attitudes about HIV-antibody testing: development and psychometric validation. AIDS Educ Prev. 1999;11(5):400–13.PubMedGoogle Scholar
  24. 24.
    Hanna KM. An adolescent and young adult condom self-efficacy scale. J Pediatr Nurs. 1999;14(1):59–66.CrossRefPubMedGoogle Scholar
  25. 25.
    Ventuneac A, Carballo-Diéguez A. Perceived effectiveness and difficulty of discussing HIV test with partners scale; 2007. Unpublished (in press)Google Scholar
  26. 26.
    Misovich SJ, Fisher WA, Fisher JD. A measure of AIDS prevention information, motivation, and behavioral skills. In: Davis CM, Yarber WL, Bauserman R, Schreer G, Davis SL, et al., editors. Sexually related measures: a compendium. Newbury Park: Sage; 1998. p. 328–37.Google Scholar
  27. 27.
    Schnall R, John R, Carballo-Dieguez A. Do high-risk young adults use the HIV self-test appropriately? Observations from a think-aloud study. AIDS Behav. 2015. doi: 10.1007/s10461-015-1240-6.
  28. 28.
    Schnall R, Rojas M, Travers J. Understanding HIV testing behaviors of minority adolescents: a health behavior model analysis. J Assoc Nurses AIDS Care. 2015;26(3):246–58.CrossRefPubMedGoogle Scholar
  29. 29.
    Carballo-Diéguez A, Frasca T, Dolezal C, Balan I. Will gay and bisexually active men at high risk of infection use over-the-counter rapid HIV tests to screen sexual partners? J Sex Res. 2012;49(4):379–87.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Marlin RW, Young SD, Bristow CC, Wilson G, Rodriguez J, Ortiz J, et al. Piloting an HIV self-test kit voucher program to raise serostatus awareness of high-risk African Americans, Los Angeles. BMC Public Health. 2014;14:1226.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Pai NP, Sharma J, Shivkumar S, Pillay S, Vadnais C, Joseph L, et al. Supervised and unsupervised self-testing for HIV in high- and low-risk populations: a systematic review. PLoS Med. 2013;10(4):e1001414.CrossRefGoogle Scholar
  32. 32.
    Eaton L, Driffin D, Smith H, Conway-Washington C, White D, Cherry C. Black men who have sex with men, sexual risk-taking, and willingness to use rapid home HIV tests. Prev Sci. 2015;16(2):321–9.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Mackellar DA, Hou SI, Whalen CC, Samuelsen K, Sanchez T, Smith A, et al. Reasons for not HIV testing, testing intentions, and potential use of an over-the-counter rapid HIV test in an internet sample of men who have sex with men who have never tested for HIV. Sex Transm Dis. 2011;38(5):419–28.CrossRefPubMedGoogle Scholar
  34. 34.
    Frye V, Wilton L, Hirshfield S, Chiasson MA, Usher D, Lucy D, et al. “Just because it’s out there, people aren’t going to use it”. HIV self-testing among young, Black MSM, and transgender women. AIDS Patient Care STDs. 2015;29(11):617–24.CrossRefPubMedGoogle Scholar
  35. 35.
    Ventuneac A, Carballo-Diéguez A, Leu C-S, Levin B, Bauermeister J, Woodman-Maynard E, et al. Use of a rapid HIV home test to screen sexual partners: an evaluation of its possible use and relative risk. AIDS Behav. 2009;13(4):731–7.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • William BrownIII
    • 1
    • 2
  • Alex Carballo-Diéguez
    • 1
    • 3
  • Rita Marie John
    • 4
  • Rebecca Schnall
    • 4
    Email author
  1. 1.HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew YorkUSA
  2. 2.Biomedical Informatics, College of Physicians and SurgeonsColumbia UniversityNew YorkUSA
  3. 3.Psychiatry, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  4. 4.School of NursingColumbia UniversityNew YorkUSA

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