HIV self-testing knowledge, attitudes, and acceptance in New York City

BackgroundHIV testing is a critical strategy for prevention. During the COVID-19 pandemic, many community-based organizations (CBOs) offering free HIV testing were unable to provide in-person services. Innovations like free HIV Self-Testing (HIVST), provided a solution and can be done outside clinical settings, help address barriers such as cost, availability, and stigma. However, HIVST uptake remains low in resource-rich settings like the US, and best practices for integrating it into existing HIV services are still undetermined.MethodsGay Men's Health Crisis (GMHC) partnered with the NYC Health Department (NYCDOHMH) to distribute free HIVST kits. From April to February 2023, survey data was collected to assess client barriers and HIVST's role in a differentiated service model.ResultsThe survey had 201 participants, 151 in the in-person testing group and 50 in the at-home group. The study revealed that 34.7% of in-person respondents were unaware that HIVST was an option. In-person testers were less likely to trust an HIVST test result compared with an in-person test result, and all testers were more likely to choose the same method they previously used. Nevertheless, there was interest in HIVST: 24% of in-person testers indicated interest in HIVST for their next test.ConclusionsHIVST can supplement in-person testing in settings with fragmented healthcare systems and limited continuity of care. Respondents demonstrated low awareness but notable interest in HIVST, suggesting its potential to improve access, particularly for populations more likely to use it than in-person options. Further research is needed to optimize HIVST implementation within existing service models.