Latent class analysis of acceptability and willingness to pay for self‐HIV testing in a United States urban neighbourhood with high rates of HIV infection. Issue 1 (1st January 2017)

• Record Type: Journal Article
• Authors: Nunn, Amy; Brinkley‐Rubinstein, Lauren; Rose, Jennifer; Mayer, Kenneth; Stopka, Thomas; Towey, Caitlin; Harvey, Julia; Santamaria, Karina; Sabatino, Kelly; Trooskin, Stacey; Chan, Philip A.
• Is Part Of: Journal of the International AIDS Society. Volume 20:Issue 1(2017)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-01-01
• Subjects: HIV self‐test -- geography -- home‐based testing -- neighbourhood; AIDS (Disease) -- Periodicals; HIV infections -- Periodicals; 616.9792005
• DOI: 10.7448/IAS.20.1.21290
• Languages: English
• ISSNs: 1758-2652

Abstract

Abstract: Introduction : Acceptability and willingness to both take and pay for HIV self‐tests (HIVSTs) in US neighbourhoods with high rates of HIV infection are not well understood. Methods : We surveyed 1, 535 individuals about acceptability and willingness to take and pay for an HIVST in a predominately African American neighbourhood with 3% HIV seroprevalence. We recruited individuals presenting for HIV screening services in a community‐based programme. Latent class analysis (LCA) grouped individuals with similar patterns of HIV‐risk behaviours and determined which groups would be most willing to use and buy HIVSTs. Results : Nearly 90% of respondents were willing to use an HIVST; 55% were willing to buy HIVSTs, but only 23% were willing to pay the market price of US $40. Four distinct groups emerged and were characterized by risk behaviours: (1) low risk ( N = 324); (2) concurrent partnerships ( N = 346); (3) incarceration and substance use ( N = 293); and (4) condomless sex/multiple partners ( N = 538). Individuals in the low‐risk class were less willing to self‐test compared to concurrent sexual partners (OR = 0.39, p = .003) and incarceration and substance use (OR = 0.46, p = .011) classes. There were no significant differences across classes in the amount individuals were willing to pay for an HIVST. Conclusions : HIVSTs were overwhelmingly acceptable but cost prohibitive; most participants were unwilling to pay the market rate of US $40. Subsidizing and implementing HIVST programmes in communities with high rates of infection present a public health opportunity, particularly among individuals reporting condomless sex with multiple partners, concurrent sexual partnerships and those with incarceration and substance use histories.