Addressing Key Issues in HIV Self-Testing Program Implementation for Black and Latino Men Who Have Sex with Men in the US South

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ABSTRACT Black and Latino men who have sex with men (BLMSM) in the US South have the highest HIV infection rates in the country. Increasing HIV testing among men who have sex with men may decrease new HIV infections in this population, yet rates of regular testing among BLMSM in the South are low. HIV self-testing (HST), or the self-administration of an HIV screening device, is an effective strategy to increase HIV testing among men whohave sex with men. However, HST implementation within health settings in the US South is limited. One possible barrier to implementation is program planners’ limited knowledge of how BLMSM in the South prefer to access HST and how much they would pay. For example, although home delivery and peer delivery are two strategies that successfully increase HST use among BLMSM elsewhere in the US, researchers have yet to determine which of these strategies BLMSM in the South prefer and their corresponding willingness to pay for each strategy. In addition, little overall is known about facilitators and barriers to initiating HST programs from the perspectives of implementation decisionmakers at public health departments, HIV / STD testing clinics, andcommunity-based organizations in the US South. In this predoctoral fellowship, I will conduct a discrete choice experiment among BLMSM (N=300) in several states in the US South (Louisiana, Mississippi, Georgia, Florida) to elicit this population’s relative preferences for several HST delivery strategies and an estimated dollar amount they would pay for each program. The delivery strategies I will evaluate through the discrete choice experiment are retail purchase at drugstores, home delivery, and peer delivery. I will also conduct semi-structured interviews (N=30) with HIV prevention program decisionmakers at various health organizations serving BLMSM in the US South to understand facilitators and barriers to HST implementation. By increasing the knowledge of HST implementation outcomes from the perspectives of patients and providers, this project will build a roadmap for the initiation of HST programs to decrease HIV incidence among one of the most disproportionately impacted populations in the US.