Virtual Model for HIV Self-Testing Demand Generation and Kit Distribution: Results From the STAR III Study in India

This study examined virtual demand-generation strategies and the acceptability, usability, and willingness to pay for HIV self-testing (HIVST) delivered through an online model in India.

The study used social media marketing, influencer collaborations, and virtual peer navigators to generate demand. Participants could order blood- or oral-fluid-based HIVST kits online for courier delivery or in-person pickup. The study operated across 50 districts in 14 states in 2 phases from April 2022 to February 2023.

The virtual demand-generation campaign reached >1.4 million individuals, with influencer campaigns reaching 830,900 and social media advertisements reaching 654,773 people. These campaigns resulted in 136 registrations from social media, 321 from influencers, and 733 from virtual peer navigators. Overall, 1190 participants registered, with 712 (66% of 1087 eligible) ordering an HIVST kit. The median age was 26 years, 74% identified as men who have sex with men, and 61% reported testing for the first time. Among those who ordered an HIVST kit, 98.9% were successfully followed up, 1.8% reported a reactive result, 80% of whom initiated antiretroviral therapy. Most participants found HIVST kits easy to use (95.9%) and interpret (93.6%). Future testing preference for HIVST was reported by 87.1%, and 72.7% expressed willingness to pay. Men who have sex with men (81.7%) and younger age groups (78.9%) demonstrated a higher willingness to pay.

The virtual HIVST model in India demonstrated high acceptability and usability among key populations despite varied willingness to pay (27% unwilling), suggesting potential for improving testing uptake.