CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

WEDNESDAY, FEBRUARY 25, 2015 Session P-Y3 Poster Session

Poster Hall

2:30 pm– 4:00 pm HIV Testing: Innovations and Scale-Up 1096 Availability and Quality of Online HIV Self-Test Kits in China and the United States Fengying Liu 2 ; Larry Han 3 ; Weiming Tang 1 ; Shujie Huang 2 ; LigangYang 2 ; Heping Zheng 2 ; BinYang 2 ; JosephTucker 1 1 University of North Carolina, Guangzhou, China; 2 Guangdong Provincial STD Control Center, Guangzhou, China; 3 University of North Carolina, Chapel Hill, NC, US

Background: Among people living with HIV, at least 20 % in the US and the majority worldwide are unaware of their serostatus. HIV test uptake remains sub-optimal, and HIV self-testing (HIVST) represents one way of expanding test uptake. The advent of large e-commerce websites in China and the United States provide a large, scalable platform for selling HIV self-test (HIVST) kits. The goal of this study was to investigate the availability and self-reported quality of HIVST kits on major e-commerce websites in China and the US. Methods: In 2013, two trained public health professionals systematically examined the availability and self-reported quality of online HIVST kits. We chose the largest e-commerce websites based on annual retail sales in China (Taobao, Jingdong) and the US (Amazon, Ebay). The number of kits sold, number of comments, test method, linkage to care, counseling personnel quality, and prices were collected through websites. HIVST counseling personnel quality included self-reports of medical training and pervious HIV counseling experience. Medical training was defined as an undergraduate degree in the health sciences or substantial training course from a medical institute. Results: We identified a total of 43 vendors that sold 38 brands of HIV self-testing kits. All Chinese brands were approved by the Chinese State Food and Drug Administration (SFDA) and 30/35 US brands were approved by the US FDA. In China and the US, all HIVST kits were sold by private companies. No Chinese vendors and only 37% (13/35) of US vendors provided HIV confirmatory testing service together with referral services. All seven Chinese and 46% (16/35) of American vendors provided general advice directing individuals to the local public health authority without specific hotline or address information. In terms of HIVST counseling, all vendors had generic customer service available, but HIVST counseling quality was poor. Only 28% (2/7) and 17% (6/35) of Chinese and US customer service employees had medical training, respectively. None of Chinese and 11% (4/38) of US customer service employees had prior counseling experience with HIV-infected individuals. Conclusions: Empirical data on linkage to care and retention in care through these HIVST systems would be useful. Ecommerce may improve uptake of HIVST, but current models driven by the private sector do not fully realize the potential of this opportunity. 1097 Home HIV Testing and Medical Care: Doing the Right Thing Charulata J. Sabharwal ; Sharmila Shah; Chi-Chi N. Udeagu New York City Department of Health and Mental Hygiene, Queens, NY, US Background: HIV testing is the initial, critical step for people with HIV into the continuum of care. The approval of the home test in 2012 addressed this by expanding accessibility of HIV testing to groups who do not test in traditional venues. However, concerns have been raised over the home test’s cost (39.99USD), uptake, and users’ willingness to seek confirmatory testing. Methods: The New York City (NYC) Health Department offers partner services and linkage to care to all persons newly diagnosed with HIV city-wide. Since 2013, home test use has been systematically collected among all such persons assigned for partner services. We analyzed demographic and behavioral characteristic data among men who have sex with men (MSM) who home tested compared to MSM who did not report home testing from January 2013 - July 2014. Results: Of the 2084 MSM assigned, 53 (2.5%) reported the use of a home test. The median age (32 years) did not differ between home test users and non-users. MSM home test users were more likely to be white (43% vs. 25%) and less likely to be black (23% vs. 37%) or Hispanic (23% vs. 31%) compared to non-users. Compared to MSM who did not home test, MSM home test users were more likely to have attended college/graduate school (71% vs. 48%, p=0.002) or test HIV negative within the past 12 months (83% vs. 62%, p=0.002). Furthermore, home testers had a lower rate of incarceration (4% vs. 9%, p=0.04). Of the 53 who home tested, 27 (51%) reported testing preliminary positive on the home test. Timely linkage to HIV care (within 3 months) after diagnosis did not differ between home test users and non-users (63% vs. 69%). Conclusions: We demonstrate that among high-risk MSM in NYC, many home test users were routine testers as opposed to infrequent or never testers. This finding suggests that the current market for such tests includes persons who already test in traditional venues but may also choose to test at home. Importantly, MSM home-testing preliminary positive sought medical attention for confirmatory testing and linkage to care. The lower uptake among MSM of color compared to white MSM will require further investigation but may reflect socioeconomic differences. To address issues relating to the current cost, the NYC health department offers home test kits to HIV exposed partners who decline testing in traditional settings. Wider home testing for some risk groups may require free or lower cost kits. 1098 Using Grindr™, a Social-Media–Based Application, to Increase HIV Self Testing Among High-Risk MenWho Have Sex With Men in Los Angeles, California, 2014 Alexandra Medline 1 ; Emily Huang 2 ; Robert Marlin 2 ; Sean DYoung 2 ; Justin Kwok 2 ; Jeffrey D. Klausner 2 1 McGill University, Toronto, Canada; 2 David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, US Background: In the United States, African American and Latino men who have sex with men (MSM) have the highest incidence of HIV infection, burden of HIV/AIDS, and about one of four are unaware of their infection. The recently FDA approved OraQuick® In-Home HIV self-test kit, in combination with an Internet-based test request system, might help reduce common barriers for testing, including poor access, stigma, and if provided for free, cost. Methods: An advertisement publicizing free HIV self-test kits targeting high-risk HIV incidence areas in Los Angeles was placed on Grindr™ from April 17 to May 29, 2014. Users were linked to http://freehivselftests.weebly.com/ to choose a method of self-test delivery: U.S mail, a Walgreens® voucher, or from a vending machine. We invited eligible users to take a survey on testing experiences. Eligible participants were African American or Latino, MSM, and > 18 years of age. UCLA IRB approved the study protocol. Results: During the campaign, the website received 11,939 unique visits (average: 284 per day) and 344 test requests. Of those 344, 230 (67%) were requests for mailed tests, 101 (29%) were for vouchers, and 13 (4%) were to use the vending machine. Of the 121 eligible study participants, 38%were between the ages of 18-30, 14%were African American, 86%were Hispanic/ Latino, 68% reported condomless anal sex in the past 3 months, 38% had only tested once in the past year, and 11% had never tested. Of the 63 surveyed respondents, 54 (95%) of 57 reported using the test was easy; 55 (96%) reported testing HIV negative, and two (4%) reported testing HIV positive. Both persons with positive test results sought confirmatory testing or medical care. Of the 63 surveyed study participants, 39 (68%) of 57 would prefer self-testing among other testing choices in the future. Conclusions: Grindr™ users seeking HIV self-testing are willing to request self-test kits online and found self-test kits acceptable, easy to use, and preferred US mail test delivery. The use of self-test kits identified at least two new cases of HIV infection among respondents; both sought medical care. HIV self-testing promotion through social networking applications has a high potential to reach untested high-risk populations who will link to care if positive.

Poster Abstracts

638

CROI 2015