“Just Because It's Out There, People Aren't Going to Use It.” HIV Self-Testing among Young, Black MSM & Transgender Women

HIV disproportionately affects young black MSM and transgender women in the US. Increasing HIV testing rates among these populations is a critical public health goal. 

Although HIV self-tests are commercially available, there is a need to better understand access to and uptake of HIV self-testing among this population. Here, we report results of a qualitative study of 30 young black MSM and transgender women residing in the New York City area to understand facilitators of and barriers to a range of HIV testing approaches, including self-testing. 

• Mean age was 23.7 years
• Over half (54%) had some college or an associate's degree, 
• yet 37% had an annual personal income of less than $10,000 per year. 
• Most (64%) participants had tested in the past 6 months; 
• venues included 
• community health/free clinics, 
• medical offices, 
• mobile testing units, 
• hospitals, 
• emergency departments, 
• and research sites. 
• Just one participant reported ever using a commercially available HIV self-test. 
• Facilitators of self-testing included 
• convenience, 
• control, 
• and privacy, particularly as compared to venue-based testing. 
• Barriers to self-testing included 
• the cost of the test, 
• anxiety regarding accessing the test, 
• concerns around correct test operation, 
• and lack of support if a test result is positive.

Participants indicated that instruction in correct test operation and social support in the event of a positive test result may increase the likelihood that they would use the self-test. 

Alongside developing new approaches to HIV prevention, developing ways to increase HIV self-testing is a public health priority for young, black MSM, and transgender women.

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By: Victoria Frye, MPH, DrPH,^1,2 Leo Wilton, PhD,^3,4 Sabina Hirshfied, PhD,⁵ Mary Ann Chiasson, DrPH,⁵DaShawn Usher,⁶ Debbie Lucy, MA,⁶ Jermaine McCrossin,⁶ Emily Greene, MPH,^1,7 and Beryl Kobin, PhD,⁸for the All About Me Study Team

¹Laboratories of Social and Behavioral Sciences, New York Blood Center, New York, New York.

²Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.

³Department of Human Development, State University of New York at Binghamton, Binghamton, New York.

⁴Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa.

⁵Public Health Solutions, New York, New York.

⁶Project ACHIEVE, Laboratory of Infectious Disease Prevention, New York Blood Center, New York, New York.

⁷Department of Epidemiology, Columbia University, New York, New York.

⁸Laboratories of Infectious Disease Prevention, New York Blood Center, New York, New York.


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