High HIV Testing Among Black/Latino Men Who Have Sex with Men Assigned to HIV Self-Testing in a National Randomized Controlled Trial.

Abstract

Background: Black/Latino men who have sex with men (MSM) in the United States have high rates of undiagnosed HIV infection. To assess whether HIV self-testing increases HIV screening among Black/Latino MSM and how HIV self-testing for Black/Latino MSM compares to White MSM, we analyzed data from a 12-month randomized controlled trial.

Methods: Participants were randomized to quarterly allocation of: HIV testing reminders (control, no HIV self-tests), home delivery of rapid HIV self-tests (standard HIV self-test), or home delivery with counseling 24 hours after opening tests (eTest). In this secondary analysis, we used Poisson regression models to evaluate HIV testing rates for the different approaches among Black/Latino MSM compared to White MSM.

Results: Of a final analytical sample of 713 participants, 353 were White MSM and 360 were Black/Latino MSM. In all approaches, we found no evidence of differences in HIV testing between White MSM and Black/Latino MSM. Predicted probabilities indicated higher testing among Black/Latino MSM assigned to the HIV self-test conditions compared to Black/Latino MSM in the control condition. The probabilities of any HIV testing among Black/Latino MSM in the standard HIV self-test, eTest, and control conditions were 92%, 90%, and 58%, respectively (all p<.05).

Conclusions: Results from this randomized controlled trial suggest that Black/Latino MSM use HIV self-tests at high rates and found no evidence that HIV self-test use differs between Black/Latino MSM and White MSM. Implementation science research is needed to increase the availability of HIV self-tests for all MSM, especially underserved populations such as Black/Latino MSM.