Can Home-Based Kits Increase HIV Testing in At-Risk Individuals?

Researchers around the world are channeling their efforts into putting an end to the HIV epidemic. A staggering 1.1 million individuals in the United States are living with the virus, and about 1 in 7 of them are not even aware of it. In order to save many lives, the need for widespread, accessible testing is paramount. The hope is that through increased testing, more individuals will learn their status, and thus, seek care, if needed.

An ongoing challenge for health officials is to reach at-risk individuals who have never been tested before. The development of a home-based testing kit might make it easier for these individuals to know their status, and could potentially assist in linking these individuals with needed care. In fact, a new study out of the Louisiana State University (LSU) School of Public Health has found that 86% of at-risk heterosexuals would use a home-based testing kit provided by mail, and, furthermore, a whopping 99% would seek treatment if presented with a positive result.

The study, published in the Journal of Acquired Immune Deficiency Syndrome, was led by William Robinson, PhD, Associate Research Professor of Behavioral & Community Health Sciences at LSU Health New Orleans.

“In 2014, 24% of new HIV infections were attributed to heterosexual activity,” Dr. Robinson said in LSU’s official press release. “Yet, many at-risk individuals do not test routinely or have never been tested.”

Because of the stigma surrounding HIV, individuals are often reluctant to visit a healthcare clinic to get tested for the virus. A home-based test offers an alternative for high-risk individuals, an alternative that might link them with much-needed treatment sooner rather than later in their disease.

The researchers surveyed 470 respondents “as part of the New Orleans arm of the Centers for Disease Control and Prevention National HIV Behavioral Surveillance of Heterosexuals at increased risk for HIV study in 2013.” All participants had to be at least 18 years of age, or older, residents of the New Orleans metropolitan area, able to take the survey in English, and had to have reported having sex with a partner of the opposite sex within the past year.

The study found that 85.56% of the participants shared they would take a home-based HIV test “if it was mailed to them by a research study or health department,” and, of that ~86%, a total fo 54.19% would return their result back to the test provider. However, 43% of those who said they would take the home-based test preferred to report their test results only to their personal doctor. Only 1.7% of participants who would take the test reported that they would not share their results with anyone.

“Our findings demonstrate that home-based testing could be an effective means to reach some heterosexuals who have never been tested,” Dr. Robinson explained.

The study did have its limitations. First, the data was self-reported; and furthermore, the “participants were recruited through respondent-driven sampling,” according to the press release.

The authors note that more research is needed to assess the epidemiologic context “under which the assumptions of these models hold true as well as the ethical and logistic considerations.” However, they stress that when it comes to the hope of controlling the HIV epidemic, increased testing is essential.

“These findings point toward a potential method for advancing the National HIV/AIDS Strategy,” the study authors noted. The National HIV/AIDS Strategy is a “5-year plan that details principles, priorities, and actions to guide our collective national response to the HIV epidemic.” One of the 4 key areas of critical focus is widespread testing and linkage to care, which would ultimately enable HIV-positive individuals to get the treatment they need early.