1. HIV Self-Testing Increases HIV Testing Frequency among High Risk MSM: A Randomized Controlled Trial  230 HIV-negative MSM at high risk for HIV acquisition in Seattle randomized for 15 months to: HIV self-testing (HIVST): access to self-tests at no cost Standard Testing: testing as usual  Aim 1: Compare number of HIV tests during follow-up among men randomized to HIVST vs. standard testing  Aim 2: Determine whether HIVST is non-inferior to standard testing with respect to markers for risk of HIV acquisition  HIV self-testing = OraQuick on oral fluids, written instructions & counseling, kits available upon request by mail/pick-up  All participants recommended to test quarterly & offered reminders to test per standard of care David A. Katz, Matthew R. Golden, James P. Hughes, Carey Farquhar, Joanne D. Stekler

2. Access to HIVST increased HIV testing Arm Number of HIV tests Mean (95% CI) ≥1 HIV test N (%) ≥Quarterly testing N (%) Self-testing5.3 (4.7-6.0)96 (98%)74 (76%) Control3.6 (3.2-4.0)92 (93%)53 (54%) P<0.0001P=0.17P=0.001

3. Effect on HIV risk & Conclusions Median ( ) and interquartile range ( | ) of male condomless anal intercourse (CAI) partners reported in last 3 months 9 months15 months Risk difference -6.8% (-16-1.6%) Odds ratio 1.08 (0.61-1.90) Incidence rate ratio 0.92 (0.64-1.33) Conclusions  HIV self-testing programs may ↑ awareness of HIV status without affecting HIV risk  Research necessary to:  Determine effect of self-testing in other settings/populations  Ensure timely linkage to HIV care  Identify cost-effective methods for implementation Poster MOPDC0103; Funded by NIMH (R01 MH086360); Clinicaltrials.gov NCT01161446