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Using a Social Network Strategy to Distribute HIV Self-Test Kits to African American and Latino MSM

Lightfoot, Marguerita A., PhD*; Campbell, Chadwick K., MPH*; Moss, Nicholas, MD, MPH; Treves-Kagan, Sarah, MPH*,‡; Agnew, Emily, PhD*; Kang Dufour, Mi-Suk, PhD, MPH*; Scott, Hyman, MD§; Sa'id, Aria M.*; Lippman, Sheri A., PhD, MPH*

JAIDS Journal of Acquired Immune Deficiency Syndromes: September 1, 2018 - Volume 79 - Issue 1 - p 38–45
doi: 10.1097/QAI.0000000000001726
Prevention Research

Background: Men who have sex with men (MSM) continue to be disproportionately impacted globally by the HIV epidemic. Studies suggest that HIV self-testing (HIVST) is highly acceptable among MSM. Social network strategies to increase testing are effective in reaching MSM, particularly MSM of color, who may not otherwise test. We tested a social network–based strategy to distribute HIVST kits to African American MSM (AAMSM) and Latino MSM (LMSM).

Setting: This study was conducted in Alameda County, California, a large, urban/suburban county with an HIV epidemic mirroring the national HIV epidemic.

Methods: From January 2016 to March 2017, 30 AAMSM, LMSM, and transgender women were trained as peer recruiters and asked to distribute 5 self-test kits to MSM social network members and support those who test positive in linking to care. Testers completed an online survey after their test. We compared peer-distributed HIVST testing outcomes to outcomes from Alameda County's targeted, community-based HIV testing programs using χ2 tests.

Results: Peer-distributed HIVST to 143 social and sexual network members, of whom 110 completed the online survey. Compared with MSM who used the County's sponsored testing programs, individuals reached through the peer-based self-testing strategy were significantly more likely to have never tested for HIV (3.51% vs. 0.41%, P < 0.01) and to report a positive test result (6.14% vs. 1.49%, P < 0.01).

Conclusion: Findings suggest that a network-based strategy for self-test distribution is a promising intervention to increase testing uptake and reduce undiagnosed infections among AAMSM and LMSM.

*Division of Prevention Sciences, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA;

Division of Communicable Disease Control & Prevention, Alameda County Public Health Department, Oakland, CA;

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; and

§Bridge HIV, San Francisco Department of Public Health, San Francisco, CA.

Correspondence to: Chadwick K. Campbell, MPH, Center for AIDS Prevention Studies, University of California San Francisco, UCSF Mail Code 0886, 550 16th Street, 3rd Floor, San Francisco, CA 94158-2549 (e-mail:

Presented in part at the 9th International AIDS Society Conference on HIV Science; July 24, 2017; Paris, France.

The authors have no funding or conflicts of interest to disclose.

Received November 20, 2017

Accepted April 27, 2018

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