US: Gay men using HIV self-tests promptly seek confirmatory testing and linkage to care, New York data suggests

Data from the partner services programme in New York City suggests that gay men who have previously used an HIV self-test tend to seek confirmatory testing without delay, according to an article published online ahead of print in Sexually Transmitted Diseases. The study also highlights socio-demographic differences between those using self-tests and other people with new HIV diagnoses, suggesting that the price of the kit discourages its use by those with lower incomes.

One of the main concerns about HIV self-testing (otherwise known as HIV home-testing) is whether people with reactive results will attend medical services for confirmatory testing. Additional tests are necessary as ‘false positive’ results do occasionally occur. If the initial result suggests infection with HIV, it must be confirmed with two more tests, using a different type of test kit each time. There is also a concern about whether people testing on their own, without a health professional present, may find a reactive result more difficult to cope with and be less likely to engage with the support and treatment services that they need.

Researching this issue is inherently challenging - as people use self-testing kits in private, health agencies and researchers cannot observe the results people get and track what individuals do next. The New York study attempts to shed light on the issue by examining data from people who used self-testing kits and who did seek confirmatory testing. But individuals who got reactive results during self-testing and did not seek any follow-up care are inevitably not included in this data set. We can only speculate as to how many such individuals there might be.

Staff at the New York City Department of Health and Mental Hygiene attempt to contact and offer partner services to all people newly diagnosed with HIV. Partner services include making contact with recent sexual partners of the newly diagnosed individual and offering them HIV testing. During interviews with newly diagnosed people, information on their HIV testing history is collected, including data on the previous use of self-testing. Read more via AIDS Map