Files
Abstract
Despite some lifted restrictions in Georgia and attempts to integrate COVID-19 response and HIV activities, provisions of HIV prevention services were still under performing. COVID-19 lockdowns imposed challenges to accessing primary prevention services-HIV testing and PrEP-through routine, conventional methods in clinic settings, outreach, and community settings; this made exploring the feasibility of free, home-based testing options essential. This study examines data from the implementation of a statewide self-testing initiative conducted across Georgia. Responses to a pre- and post-survey completed by individuals requesting to receive an HIV self-test (HIVST) by mail delivery or pick-up were analyzed to understand the impact of health insurance on testing history and predictors for requesting HIVST using different distribution request methods. Qualitative responses were provided from open-ended questions and analyzed to offer insight into individuals’ experience using the HIVST, attitudes about HIV prevention and health seeking behaviors. Results showed there is an association between health insurance status and HIV testing history as well as an association between HIVST distribution request method and reasons for requesting an HIVST. The odds of requesting an HIVST distributed by mail was 2 times greater for those with no health insurance compared to participants with insurance and 9 times greater for those testing more than 1 year ago. In-home privacy was a primary reason across both request distribution methods for requesting an HIVST. 50% of respondents reported testing for HIV for the first time because of the option to use the HIVST at home. Also, participants reported having anxiety using the HIVST at home, but instructions were easy to follow, and they noted an overall general appreciation for the convenience of testing at home. In conclusion, mailed HIVST distribution compared to pick-up is a feasible option to reach individuals who are not testing for HIV annually and a means to educate about PrEP. Individuals with health insurance are more likely to have a previous HIV testing; health insurance status can influence the decision to consider use of HIVST if there is a cost. Underserved and marginalized communities could benefit from the option of HIVST to encourage HIV/STI prevention and PrEP knowledge.