Increasing HIV testing among non-urban YMSM: can home-based rapid HIV self-testing help?

Abstract

We describe HIV testing history, barriers to testing and testing preferences among young men who have sex with men (YMSM) who live outside of large urban centers. We present data showing that home-based rapid HIV self-testing may be effective in increasing testing rates of these YMSM, who are less likely to have been tested than their urban counterparts.

Proposal Summary

Background: Young adult MSM (YMSM) residing in smaller US communities likely face greater HIV testing barriers than YMSM from large urban areas and surrounding suburbs. To address the lack of knowledge on this topic, we compared higher HIV risk US YMSM residing in large urban areas vs. smaller communities according to self-reported HIV testing barriers and interest in oral-fluid and fingerstick (not-yet-commercially-available in the US) home-based rapid HIV self-testing. Methods: We surveyed a national sample of 18-24-year-old US black, Hispanic and white YMSM recruited through social media who reported that they had condomless anal intercourse within the past year. We compared participants residing in large urban areas vs. smaller communities (medium and smaller cities, towns, and rural areas) according to HIV testing history, knowledge of HIV testing sites, comfort with asking their primary care provider (PCP) about HIV testing, and interest in home-based rapid HIV self-testing. Results: Among the 1835 participants, 59% resided outside of large urban areas. YMSM residing in smaller communities were less likely than those from large urban areas to have been previously tested for HIV (77 vs. 88%; OR 1.85 (1.50-2.28)) or tested within the past year (65 vs. 77%; OR 1.83 (1.49-2.27)). More YMSM residing in smaller communities than those from large urban areas were not comfortable asking their PCP for an HIV test (23 vs. 17%; OR 1.41 (1.11-1.78)), and fewer knew community organizations that offer HIV testing (59 vs. 73%; OR 1.87 (1.51-2.33)). However, YMSM residing in smaller communities were more likely than those from large urban areas to want to use oral fluid (17 vs 11%; OR 1.73 (1.29-2.34)) or fingerstick (39 vs. 30%; OR 1.49 (1.19-1.88)) home-based rapid HIV self-testing for their next HIV test. They also were more apt to believe that oral fluid home-based rapid HIV self-testing would motivate them to get tested sooner (38 vs. 32%; OR 1.32 (1.06-1.65)) and more often (36 vs. 25%; OR 1.66(1.31-2.10)). Conclusions: Higher HIV risk US YMSM residing in smaller US communities face greater HIV testing barriers than their large urban area counterparts. Home-based rapid HIV self-testing might help improve HIV testing utilization among this population.

Relevance And Significance

Innovative strategies and tools for prevention and intervention in rural communities Medical access and compliance issues among rural populations

Session Format

Poster Session

Keywords

YMSM, HIV Testing, Rural

Publication Type and Release Option

Presentation (Open Access)

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Sep 21st, 5:30 PM Sep 21st, 7:30 PM

Increasing HIV testing among non-urban YMSM: can home-based rapid HIV self-testing help?

We describe HIV testing history, barriers to testing and testing preferences among young men who have sex with men (YMSM) who live outside of large urban centers. We present data showing that home-based rapid HIV self-testing may be effective in increasing testing rates of these YMSM, who are less likely to have been tested than their urban counterparts.