Willingness to Participate in At-Home HIV Testing Among Young Adults Who Use Opioids in Rural Appalachia

Abstract

New HIV infections associated with injection drug use are of major concern in rural US communities. This study explores acceptability of, consent for, and uptake of free at-home HIV testing among people who use drugs (PWUD) in one of the nation's epicenters for drug-related harms and HIV vulnerability: Rural Central Appalachia. Eligible participants were 18-35 years old, lived in Appalachian Kentucky, and reported using opioids to get high in the previous 30 days. A majority reported being likely (63.6%, 96/151) to take a free at-home HIV tests and 66.9% (101/151) consented to receive one. Among those who were randomly selected to receive a Home Access HIV-1 test kit (n = 37), 37.8% mailed in blood spots and 21.6% called to receive results. This study provides evidence that PWUD may be willing to take an at-home test, but other barriers may inhibit actual completion.

Preliminary Acceptability of a Home-Based Peripheral Blood Collection Device for Viral Load Testing in the Context of Analytical Treatment Interruptions in HIV Cure Trials: Results from a Nationwide Survey in the United States

“…The ongoing COVID-19 pandemic has further precipitated increased appreciation towards home-testing technologies to reduce the risk of SARS-CoV-2 exposure in clinic settings and facilitate self-testing [13]. Previous studies related to HIV [14][15][16][17][18][19] and sexually transmitted infections (STIs) [20][21][22][23][24][25][26][27][28][29] have demonstrated successful use of self-specimen collection mechanisms. Other successful examples of self-specimen collection outside of HIV and STI management include tuberculosis [30], hypertension and cardiovascular health [31,32] and diabetes (in existence since the 1970s) [33].…”

Preliminary Efficacy of a Theory-Informed Intervention to Increase COVID-19 Testing Uptake Among People Who Inject Drugs in San Diego County: Findings From a Pilot Randomized Controlled Trial

“…Furthermore, as the COVID-19 pandemic limited SSP access in many settings [ 42 , 52 , 53 ], it may be worthwhile to explore alternative approaches such as the distribution of COVID-19 self-test kits through vending machines or peer networks. However, while self-testing for other infectious diseases (e.g., HIV) holds promise for PWID [ 54 , 55 ], concerns regarding poor adherence to quarantine guidelines following COVID-19 self-testing in the U.S. general population [ 56 ] underscore the need for more research on these models [ 56 ].…”

Perceptions and Experiences of Returning Self-collected Specimens for HIV, Bacterial STI and Potential PrEP Adherence Testing among Sexual Minority Men in the United States

“…Attention to the possible size of the return package might also be warranted. For example, some participants in a study conducted in rural Appalachia were not able to fit packages containing self-collected finger-stick blood samples for HIV testing in their household mailboxes, necessitating travel to a post office which likely served as a barrier to specimen return for those having to travel long distances [ 63 ]. Our use of different colored bags (i.e., red, blue, green, yellow and black) with matching color-coded instructions for self-collecting each type of specimen elicited highly positive reactions from our participants.…”