March 4, 2014
One of the biggest obstacles in the way of getting people tested for HIV is overcoming stigma, which is seen in forms big and small, like the tone of a receptionist at a doctor's office. HIV-associated stigma prompts fear, thus causing individuals to avoid testing because of a partner's potential reaction to the results. What people don't understand is that HIV is everyone's problem. HIV has the potential to affect anyone, regardless of sexual orientation, gender, age, location and even with use of protection (i.e., pre-exposure prophylaxis, condoms).
Home-based HIV testing kits are becoming a new tool to get individuals to know their status, and get into treatment if needed. Traditionally, anyone could buy a home-based testing kit, though they still have to go through a potentially judgmental middle man (the cashier), and they're a bit pricey -- priced at about $40.
The Digital Health Behavior Change lab conducted a study in regard to home-based HIV testing kits and found that vending machines could be used to distribute these HIV tests. We had a vending machine installed at the Los Angeles Gay and Lesbian Center where people could anonymously get a free home-based HIV testing kit. People who went to the vending machine found out about it via their friends who were in our sister study, Harnessing Online Peer Education (HOPE). The participants entered codes and the machine dispensed a free kit, which included an OraQuick test that only required an oral swab to test for HIV. Individuals would get their test results back in a matter of 20 minutes.
Can home-based HIV testing kits reach people who are at high risk? There is not a short and straightforward answer. It depends on circumstances. In our case, we placed the vending machine in an area where it would reach people who are at high risk. But just because several drug stores in West Hollywood (an area home to many populations perceived to be at high risk for contracting HIV) sell home-based HIV tests doesn't mean the kits will reach the target populations, because factors such as stigma and proximity to these drug stores may impact whether they get the test.
The main objective of many HIV prevention CBOs is to get individuals tested. Our lab's mission is to use technologies to improve health-related attitudes and behaviors, such as treating prevention behaviors as a form of treatment. More people could have frequented the vending machine, which is why we need more ideas on where the vending machine will "fit in," but also be frequented by populations that are disproportionately at risk of contracting HIV. Additionally, besides vending machines, what are other mechanisms we can use to get people these home-based kits while granting anonymity at the same time? Please tweet me your thoughts (@cdbucla) and "like us" on Facebook.
Derek S. Hernandez is an undergraduate at the University of California, Los Angeles, with a major in Sociobehavioral Anthropology. He is a student involved in interdepartmental research under Sean Young, Ph.D., M.S., at the UCLA David Geffen School of Medicine, Department of Family Medicine, Center for Digital Behavior. Derek studies the behavioral aspects of HIV-positive men and researches new implementations of HIV prophylaxis via social media. Derek is passionate about the dynamics of LGBTQ health care and ensuring accessibility and retention of care for patients, especially HIV/AIDS patients. He is notably proud for holding two student intern positions at UCLA Health System and currently at Cedars-Sinai Medical Center, where he works alongside physicians and nurses to ensure patient safety and adherence to quality measures. Derek plans ultimately to earn his doctorate in nursing practice and pursue a career as an acute care nurse practitioner. You may contact Derek directly at firstname.lastname@example.org.