WP 2 Feasibility of HIV Self-Test Vouchers to Raise Community-Level Serostatus Awareness, Los Angeles

Tuesday, June 10, 2014
Pre-function Lobby (M2)
Robert Marlin, BS, MD candidate, School of Medicine, David Geffen School of Medicine at the Univeristy of California, Los Angeles, Los Angeles, CA, Sean Young, PhD, MS, Department of Family Medicine, University of California, Los Angeles, Claire C Bristow, MSc, Program in Global Health, UCLA, Los Angeles, CA, Jose Ortiz, BS candidate, University of California, Los Angeles, Rhea Mathew, BS candidate, Univsersity of California, Los Angeles, Keith Daniel, Pharm.D., Community, A Walgreens Pharmacy, Greg Wilson, none, Reach LA, Jeffrey Rodriguez, none, LA Gay & Lesbian Center and Jeffrey Klausner, MD, MPH, Division of Infectious Diseases and Program in Global Health, David Geffen School of Medicine and Fielding School of Public Health, Los Angeles, CA

Background:  Up to half of all new HIV cases in Los Angeles may be caused by the 20-30% of men who have sex with men (MSM) with unrecognized HIV infection. MSM are at higher risk for being sero-unaware and might benefit from increased access to novel testing methods, such as the recently FDA-approved OraQuick In-Home HIV Test.

Methods: From July-November 2013, we examined the feasibility of implementing a voucher program for free OraQuick tests targeting high-risk MSM in Los Angeles. We determined feasibility based on: (1) the establishment of a voucher redemption and third-party payment system, (2) the use of community-based organizations (CBOs) to disseminate vouchers, and (3) an anonymous telephone survey collecting user demographics, sexual behavior, prior testing practices and self-testing experience. We defined high-risk MSM as those with > 1 partner, untested for HIV in the past 6 months and with inconsistent condom use. We calculated descriptive statistics using Microsoft Excel and STATA 12.

Results: We partnered with Walgreens to create a voucher and third-party reimbursement system for free OraQuick tests. Of the 641 vouchers supplied to CBOs and other distributors, 274 (42.7%) went to clients; 50 (18.2%) clients redeemed a voucher. Forty-one (82%) of 50 voucher-redeemers were surveyed: 10 (24.4%) were high-risk MSM. Three (30%) high-risk MSM reported being comfortable or very comfortable while redeeming their voucher. Seven (70%) reported being likely or very likely to use a voucher again.  Three (100%) of 3 respondents newly testing HIV-positive sought medical care.

Conclusions: Developing a voucher system to promote HIV self-testing with linkage-to-care was feasible. Our survey suggests that high-risk MSM will likely use a voucher again, but their comfort level during redemption needs improvement. Further research on providing access to free HIV self-test kits through different methods like the US mail or vending machines is warranted.