HIV self-testing in cis women in Canada: The GetaKit study.

Background: In light of ongoing HIV diagnoses among cis women, despite decreases in other populations, such as men who have sex with men, various testing approaches, including HIV self-tests are being targeted at cis women as a means of identifying undiagnosed HIV infections and of linking those with positive test results to care. Little, however, is known about risk characteristics of cis women who access HIV self-tests in Canada.

Objectives: Our objectives were to examine demographic characteristics, risk factors, and test results of cis women who obtained HIV self-tests through the HIV self-testing platform, GetaKit.ca.

Design: GetaKit.ca was an observational cohort study that provided free HIV self-tests to Canadians with reported risk factors for HIV acquisition.

Methods: We completed an analysis of cis women who ordered HIV self-tests from GetaKit.ca between April 1, 2021 and May 31, 2023. Data analysis involved tabulating frequencies and means, plus chi-square calculations to determine significant differences between cis women and cis men who obtained HIV self-tests.

Results: During the study period, 7420 orders for HIV self-tests were made through GetaKit.ca; 22% of these orders were made by cis women. Compared to cis men, cis women had significantly higher reported rates of injection drug use and significantly lower reported rates of prior sexually transmitted infection testing, HIV testing (with more cis women indicating their last HIV test was more than 12 months ago), and reporting HIV self-test results. Despite this, we found no differences in the number of cis women with a positive HIV self-test compared to cis men (positivity rate of 0.2% versus 0.3%, respectively).

Conclusion: Our findings showed less overall uptake of HIV testing in cis women, despite matched risks and positive test results. Future interventions to engage cis women in HIV testing should include increased access points for HIV self-tests and enhanced linkage to care pathways to HIV pre-exposure prophylaxis or HIV treatment.