Rapid home HIV testing among African American men who have sex with men: Implications for message framing

Background: African American men who have sex with men (AAMSM) experience a disproportionate burden of HIV infections. Recently, FDA approved rapid home-based HIV testing (RHT); this test may serve as an important tool for fighting the HIV epidemic among AAMSM. However, little is known about RHT beliefs, perceptions and use among AAMSM. Furthermore, there has been limited guidance provided to men on using RHT with sex partners. Methods: We surveyed men attending a Black Gay Pride Festival and asked them to report on awareness of, experiences with and intentions to use RHT; and recent sex behavior. Results: 585 AAMSM were included the study; 27% reported being HIV positive. Around half of the sample (48%) had heard of RHT, 13% had ever used RHT. A majority of both HIV negative/unknown and HIV positive men reported intentions to use RHT before sex with a partner. Men who reported the greatest sexual risk taking were least likely to report intentions of using RHT. Conclusions: Based on the current findings and review of the literature, we have developed recommendations for developing message framing around the use of RHT. These components include considerations regarding expectations about the role of RHT in HIV prevention, access to RHT, social factors relevant to using RHT with partners, and linkage-to-care. In order to realize the full potential of RHT for HIV prevention, we must take steps now to best address how RHT will be scaled-up, in particular among populations in greatest need.