title: Piloting an HIV self-test kit voucher program to raise serostatus awareness of high-risk African Americans, Los Angeles.
abstract: BACKGROUND
  Up to half of all new HIV cases in Los Angeles may be caused by the 20-30% of men who have sex with men (MSM) with unrecognized HIV infection. Racial/ethnic minority MSM are at particularly high risk for being sero-unaware and due to stigma and poor healthcare access might benefit from novel private, self-testing methods, such as the recently FDA-approved OraQuick® In-Home HIV Test.
  
  
  METHODS
  From July-November 2013, we undertook a pilot study to examine the feasibility of a voucher program for free OraQuick® tests targeting African American MSM in Los Angeles. We determined feasibility based on: (1) the establishment of a voucher redemption and third-party payment system, (2) the willingness of community-based organizations (CBOs) to disseminate vouchers, and (3) the collection of user demographics, test and linkage-to-care results with an anonymous telephone survey.
  
  
  RESULTS
  We partnered with Walgreens® to create a voucher and third-party reimbursement system for free OraQuick® tests. Voucher distribution was divided into two periods. In total, 641 vouchers were supplied to CBOs: 274 (42.7%) went to clients and of those 53 (19.3%) were redeemed. Fifty (18.2%) of the 274 clients were surveyed: 44 (88%) were African American, 39 (78%) reported being likely to repeat voucher use, 44 (88%) reported reviewing pre-test information, and 37 (74%) the post-test information. Three (6%) of 50 survey respondents reported newly testing HIV-positive of whom all (100%) reported seeking medical care. Two withheld their results, both of whom also sought medical care.
  
  
  CONCLUSIONS
  Developing and partnering with a commercial pharmacy to institute a voucher system to facilitate HIV self-testing with linkage-to-care was feasible. Our findings suggest the voucher program was associated with increasing the identification of new cases of HIV infection with high rates of linkage to care. Expanded research and evaluation of voucher programs for HIV self-test kits among high-risk groups is warranted.
authors.affiliation: Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Le Conte Avenue, Los Angeles, CA, USA. rmarlin@mednet.ucla.edu.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Marlin
authors.forename: Sean D
authors.initials: SD
authors.lastname: Young
authors.forename: Claire C
authors.initials: CC
authors.lastname: Bristow
authors.forename: Greg
authors.initials: G
authors.lastname: Wilson
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rodriguez
authors.forename: Jose
authors.initials: J
authors.lastname: Ortiz
authors.forename: Rhea
authors.initials: R
authors.lastname: Mathew
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Klausner
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001364:Awareness; D003625:Data Collection; D059026:Diagnostic Self Evaluation; D015658:HIV Infections / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007349:Insurance, Health, Reimbursement; D015141:Los Angeles; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D010593:Pharmaceutical Services; D010865:Pilot Projects; D012306:Risk; D012747:Sexual Partners; D055815:Young Adult