Can Home-Based HIV Rapid Testing Reduce HIV Disparities Among African Americans in Miami?

Abstract

Sixty percent of African Americans have had an HIV test, yet this population disproportionately contributes to AIDS mortality, suggesting that testing is not occurring early enough to achieve optimal outcomes. OraQuick, the first Food and Drug Administration-approved home-based HIV rapid test (HBHRT) could potentially increase testing rates. We assessed whether community health workers (CHWs) paired with HBRHT could improve HIV screening and health care access among African Americans in Miami, Florida. In October-November 2013, 60 African Americans were enrolled and randomized to the experimental condition, which received CHW assistance to complete HBHRT, or the control condition, which were instructed to complete HBHRT independently. Intervention participants were significantly (p ≤ .05) more likely than control participants to complete HBHRT and, if positive, get linked to HIV care (100% vs. 83%) χ(2) (1, N = 60) = 5.46, p ≤ .02. We concluded that CHW-assisted HBHRT may be a promising strategy to improve HIV testing and care among African Americans.

Systematic Review and Meta-analysis of Linkage to HIV Care Interventions in the United States, Canada, and Ukraine (2010–2021)

“…We summarize key characteristics of included studies in Table 1 . Four studies (31%) were quasi-experimental (pre-post studies) [ 31 – 34 ]; three (23%) were experimental studies, including one non-randomized experimental study [ 35 ] and two controlled trials [ 36 , 37 ]. Six (46%) were cohort studies [ 38 – 43 ].…”

What do Key Stakeholders Think About HIV Self-Testing in Canada? Results from a Cross-Sectional Survey

“…A US study found that participants were more likely to complete an HIV self-test and get linked to care in the presence of a community health worker (e.g. respected peer in the community, familiar with cultural norms), compared to self-testing independently [ 24 ]. Various self-testing strategies are possible: supervised self-testing (set up self-testing kiosks in clinics or outreach community sites/vans), unsupervised self-testing (purchase of self tests from pharmacies or online sites, and provision of a toll free number for linkages to counselling and care) [ 2 ].…”

Use of Community Health Workers to Help End the Epidemic of Sexually Transmitted Infections

“…8,14,15 CHWs have demonstrated effectiveness in HIV prevention by encouraging people to know their HIV status, educating and testing diverse populations, reducing stigma, and linking people who test positive to health care. 4,[7][8][9][10]16,17 Given the demonstrated strengths and history of CHWs working in HIV prevention and care, CHWs could play a vital role in addressing STIs. In the STI field, CHWs could perform a range of tasks, including aiding in STI prevention and education, referring people to testing and treatment, and helping patients enter and navigate care.…”

“…8,14,15 CHWs have demonstrated effectiveness in HIV prevention by encouraging people to know their HIV status, educating and testing diverse populations, reducing stigma, and linking people who test positive to health care. 4,7-10,16,17…”

“…The American Public Health Association and the National Association of Community Health Workers define CHWs as “frontline public health workers who are trusted members and/or have a close understanding of the community served.” 2 CHWs have a long history in the HIV field; numerous studies have demonstrated CHWs effectively supporting people living with HIV to address social determinants of health, both as part of a clinical team 3-7 and in the community. 8-10 However, the CHW workforce is a largely untapped resource for addressing STIs more broadly. Meanwhile, the Medicaid program, which covers 86 million people 11 and pays for a large share of STI-related visits, 12 is still in the early stages of determining how to best support and engage the CHW workforce.…”