HIV Testing at Home?

摘要

HIV testing rates were threefold higher in high-risk emergency department patients given take-home tests than in controls. Many patients at highest risk for contracting HIV do not have regular medical care and may be unable to access outpatient HIV testing sites. The emergency department (ED) has, in much of the U.S., become an important site for HIV screening (NEJM JW Emerg Med Mar . 2018 and Ann Emerg Med 2018; 72:29). However, EDs are crowded, and visits may present problems (e.g., privacy, cost, transportation) for patients needing testing. Enter at-home HIV testing. In this single-ED study, 100 high-risk patients who tested negative for HIV were randomized to receive either a take-home test kit or a brochure on the importance of regular repeated HIV testing (control group). The home-test group also received instructions on test interpretation and next steps if the test was either indeterminate or reactive. Notably, the baseline seroprevalence of HIV in this ED is relatively high, at 6%. At 3 months, 34 participants in the home-test group and 37 controls completed a follow-up phone survey. Of these, 65% in the home-test group reported having had been tested, all with the home kit, compared with 19% of controls (adjusted relative risk, 3.95). No patients reported positive tests.