RESEARCH PAPER
HIV self-testing during COVID-19 in Santa Clara County, California, USA
1
County of Santa Clara Public Health Department, California, USA
Submission date: 2023-08-10
Acceptance date: 2023-09-29
Publication date: 2024-02-13
HIV & AIDS Review 2024;23(1):21-28
KEYWORDS
TOPICS
ABSTRACT
Introduction:
During COVID-19, healthcare providers reported decreased testing volumes, which meant fewer people knew their HIV status. To improve testing volumes, The County of Santa Clara Public Health Department offered a pilot HIV self-testing (HIVST) program for eligible populations.
Material and methods:
The purpose of this study was to understand overall reach of the intervention and effectiveness of strategies used to raise the program awareness from November 2021 to August 2022, using an observational study design. Participants were recruited through both in-person and digital outreach methods. Individuals completed an online survey in order to participate in the study. Research team collected and analyzed all responses using descriptive analysis.
Results:
A total of 458 individuals participated in the program. Of participants 232 that responded to optional questions the majority (77%) were identifying as male and 7% identifying as transgender, gender non-binary, or genderqueer. Social media advertisements on gay dating apps and outreach at community events were identified as effective methods for increasing awareness. Of the total participants, 21% had never taken an HIV test before, 58% selected this program for convenience reasons, and 41% received pre-exposure prophylaxis (PrEP) services.
Conclusions:
HIVST programs have the potential to address barriers in accessing testing services. Healthcare providers are encouraged to offer HIVSTs as options for patients.
During COVID-19, healthcare providers reported decreased testing volumes, which meant fewer people knew their HIV status. To improve testing volumes, The County of Santa Clara Public Health Department offered a pilot HIV self-testing (HIVST) program for eligible populations.
Material and methods:
The purpose of this study was to understand overall reach of the intervention and effectiveness of strategies used to raise the program awareness from November 2021 to August 2022, using an observational study design. Participants were recruited through both in-person and digital outreach methods. Individuals completed an online survey in order to participate in the study. Research team collected and analyzed all responses using descriptive analysis.
Results:
A total of 458 individuals participated in the program. Of participants 232 that responded to optional questions the majority (77%) were identifying as male and 7% identifying as transgender, gender non-binary, or genderqueer. Social media advertisements on gay dating apps and outreach at community events were identified as effective methods for increasing awareness. Of the total participants, 21% had never taken an HIV test before, 58% selected this program for convenience reasons, and 41% received pre-exposure prophylaxis (PrEP) services.
Conclusions:
HIVST programs have the potential to address barriers in accessing testing services. Healthcare providers are encouraged to offer HIVSTs as options for patients.
REFERENCES (48)
1.
HIV.gov. U.S. Statistics [Internet]. HIV.gov. 2021. Available from: https://www.hiv.gov/hiv-basics... (Accessed: 12.09.2022).
2.
CDC MMWR. Late HIV Testing – 34 States, 1996-2005 [Internet]. 2009. Available from: https://www.cdc.gov/mmwr/previ... (Accessed: 12.09.2022).
3.
California Department of Public Health, Office of AIDS, California HIV Surveillance Report – 2019. 2019; 16.
4.
Santa Clara County PHD. STI and HIV Annual Report 2019-2020 [Internet]. 2021. Available from: https://publichealth.sccgov.or....
5.
Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med 2011; 365: 493-505.
6.
Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 transmission. N Engl J Med 2016; 375: 830-839.
7.
Attia S, Egger M, Müller M, Zwahlen M, Low N. Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis. AIDS 2009; 23: 1397-1404.
8.
Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group. N Engl J Med 2000; 342: 921-929.
9.
Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016; 316: 171-181.
10.
Inungu JN. Potential barriers to seeking human immunodeficiency virus testing among adults in the United States: data from the 1998 National Health Interview Survey. AIDS Patient Care STDs 2002; 16: 293-299.
11.
Ebrahim SH, Anderson JE, Weidle P, Purcell DW. Race/ethnic disparities in HIV testing and knowledge about treatment for HIV/AIDS: United States, 2001. AIDS Patient Care STDs 2004; 18: 27-33.
12.
CDC. HIV and Young Men Who Have Sex With Men [Internet]. 2014. Available from: https://www.cdc.gov/HealthyYou... (Accessed: 13.09.2022).
13.
Rendina HJ, Jimenez RH, Grov C, Ventuneac A, Parsons JT. Patterns of lifetime and recent HIV testing among men who have sex with men in New York city who use Grindr. AIDS Behav 2014; 18: 41-49.
14.
Landovitz RJ, Tseng CH, Weissman M, et al. Epidemiology, sexual risk behavior, and HIV prevention practices of men who have sex with men using GRINDR in Los Angeles, California. J Urban Health Bull N Y Acad Med 2013; 90: 729-739.
15.
DiNenno EA, Delaney KP, Pitasi MA, et al. HIV testing before and during the COVID-19 pandemic – United States, 2019-2020. MMWR Morb Mortal Wkly Rep 2022; 71: 820-824.
16.
Lopez-Quintero C, Neumark YD. Barriers to HIV-testing among Hispanics in the United States: analysis of the National Health Interview Survey, 2000. AIDS Patient Care STDS 2005; 19: 672-683.
17.
Hershow RB. Notes from the field: HIV outbreak during the COVID-19 pandemic among persons who inject drugs – Kanawha County, West Virginia, 2019-2021. MMWR Morb Mortal Wkly Rep 2022; 71. Available from: https://www.cdc.gov/mmwr/volum....
18.
Campbell CK, Lippman SA, Moss N, Lightfoot M. Strategies to increase HIV testing among MSM: a synthesis of the literature. AIDS Behav 2018; 22: 2387-2412.
19.
Wise JM, Ott C, Azuero A, et al. Barriers to HIV testing: patient and provider perspectives in the deep south. AIDS Behav 2019; 23: 1062-1072.
20.
Schwarcz S, Richards TA, Frank H, et al. Identifying barriers to HIV testing: personal and contextual factors associated with late HIV testing. AIDS Care 2011; 23: 892-900.
21.
Conway DP, Holt M, Couldwell DL, et al. Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney. J Int AIDS Soc 2015; 18: 20221. doi: 10.7448/IAS.18.1.20221.
22.
Goyal MK, Dowshen N, Mehta A, Hayes K, Lee S, Mistry RD. Pediatric primary care provider practices, knowledge, and attitudes of human immunodeficiency virus screening among adolescents. J Pediatr 2013; 163: 1711-1715.e6. doi: 10.1016/j.jpeds.2013.08.023.
23.
Govindasamy D, Ford N, Kranzer K. Risk factors, barriers and facilitators for linkage to antiretroviral therapy care: a systematic review. AIDS Lond Engl 2012; 26: 2059-2067.
24.
Wray T, Chan PA, Simpanen E, Operario D. eTEST: developing a smart home HIV testing kit that enables active, real-time follow-up and referral after testing. JMIR MHealth UHealth 2017; 5: e62. doi: 10.2196/mhealth.6491.
25.
Ventuneac A, Carballo-Diéguez A, Leu CS, 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: 731-737.
26.
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: 379-387.
27.
Rosengren AL, Huang E, Daniels J, Young SD, Marlin RW, Klaus-ner JD. Feasibility of using GrindrTM to distribute HIV self-test kits to men who have sex with men in Los Angeles, California. Sex Health 2016; 10.1071/SH15236.
28.
Huang E, Marlin RW, Young SD, Medline A, Klausner JD. Using GrindrTM, a smartphone social networking application, to increase HIV self-testing among Black and Latino men who have sex with men in Los Angeles, 2014. AIDS Educ Prev 2016; 28: 341-350.
29.
UNAIDS. Global AIDS update 2019 – Communities at the centre – Defending rights, breaking barriers, reaching people with HIV services [Internet]. 2019. Available from: https://www.unaids.org/sites/d... (Accessed: 19.09.2022).
30.
Mackellar D. The AIDA model: the evolution of awareness: Douglas MacKellar [Internet]. Available from: https://blogs.ubc.ca/douglasm... (Accessed: 27.02.2023).
32.
Figure 1. The AIDA model in advergames context [Internet]. ResearchGate. Available from: https://www.researchgate.net/f... (Accessed: 27.02.2023).
33.
Sabin LL, Semrau K, DeSilva M, et al. Effectiveness of community outreach HIV prevention programs in Vietnam: a mixed methods evaluation. BMC Public Health 2019; 19: 1130. doi: 10.1186/s12889-019-7418-5.
34.
Krabbe J, Jiao S, Guta A, Slemon A, Cameron AA, Bungay V. Exploring the operationalisation and implementation of outreach in community settings with hard-to-reach and hidden populations: protocol for a scoping review. BMJ Open 2021; 11: e039451. doi: 10.1136/bmjopen-2020-039451.
35.
Nguyen MP, Sembajwe S, Rompalo AM, Zenilman JM. Impacts of sexually transmitted disease/HIV outreach sites on the effectiveness of detecting new infections in Baltimore City, 2015 to 2018. Sex Transm Dis 2021; 48: 1-4.
36.
Olawepo JO, Pharr JR, Kachen A. The use of social marketing campaigns to increase HIV testing uptake: a systematic review. AIDS Care 2019; 31: 153-162.
37.
Wei C, Herrick A, Raymond HF, Anglemyer A, Gerbase A, Noar SM. Social marketing interventions to increase HIV/STI testing uptake among men who have sex with men and male-to-female transgender women. Cochrane Database Syst Rev 2011; 9: CD009337.
38.
Firestone R, Rowe CJ, Modi SN, Sievers D. The effectiveness of social marketing in global health: a systematic review. Health Policy Plan 2017; 32: 110-124.
39.
O Murchu E, Marshall L, Teljeur C, et al. Oral pre-exposure prophylaxis (PrEP) to prevent HIV: a systematic review and meta-analysis of clinical effectiveness, safety, adherence and risk compensation in all populations. BMJ Open 2022; 12: e048478. doi: 10.1136/bmjopen-2020-048478.
40.
CDC. HIV Cost-effectiveness | Guidance | Program Resources | HIV/AIDS | CDC [Internet]. 2022. Available from: https://www.cdc.gov/hiv/progra... (Accessed: 27.10.2022).
41.
Team PD. How Much Does PrEP Cost? [Internet]. PrEP Daily. 2020. Available from: https://prepdaily.org/how-much... (Accessed: 27.10.2022).
42.
McManus KA, Killelea A, Honeycutt E, An Z, Keim-Malpass J. Assisters Succeed in Insurance Navigation for People Living with HIV and People at Increased Risk of HIV in a Complex Coverage Landscape. AIDS Res Hum Retroviruses 2020; 36: 842-851.
43.
Wood BR, Ballenger C, Stekler JD. Arguments for and against HIV self-testing. HIVAIDS Auckl NZ 2014; 6: 117-126.
44.
Patel RR, Few TE, Div M, et al. A summary of HIV self-testing program models and lessons learned. Centers for Disease Control and Prevention. 2022. Available at: https://www.cdc.gov/hiv/pdf/te....
45.
HIV.gov. HIV Self-Testing Programs to Improve Testing Uptake and Increase Diagnoses [Internet]. HIV.gov. Available from: https://www.hiv.gov/blog/juris... (Accessed: 27.10.2022).
46.
Hatzold K, Gudukeya S, Mutseta MN, et al. HIV self-testing: breaking the barriers to uptake of testing among men and adolescents in sub-Saharan Africa, experiences from STAR demonstration projects in Malawi, Zambia and Zimbabwe. J Int AIDS Soc 2019; 22 Suppl 1: e25244. doi: 10.1002/jia2.25244.
47.
Nkuna E, Nyazema NZ. HIV self-testing, self-stigma and HAART treatment at the University of Limpopo: health sciences students’ opinion and perspectives. Open AIDS J 2016; 10: 78-82.
48.
UNAIDS. UNAIDS Fact Sheet 2021 [Internet]. 2022. Available from: https://www.usaid.gov/global-h... (Accessed: 27.10.2022).
Share
RELATED ARTICLE
| eISSN: | 1732-2707 |
| ISSN: | 1730-1270 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
