1. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University USE OF A RAPID HIV HOME TEST TO SCREEN POTENTIAL SEXUAL PARTNERS PREVENTS HIV EXPOSURE IN A HIGH RISK SAMPLE OF MSM Alex Carballo-Diéguez, Ivan Balan, Timothy Frasca, Curtis Dolezal, Juan Valladares HIV Center for Clinical and Behavioral Studies, NYS Psychiatric Institute and Columbia University, New York, NY, USA This research was supported by a NIMH grant (R01-MH079692; PI, Alex Carballo-Diéguez, Ph.D.) and a NIMH center grant (P30-MH43520; PI: Anke A. Ehrhardt, Ph.D.).

2. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University Study Design

3. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University Study Design Prior work on high risk MSM (bareback sex) Study Question  Would high-risk MSM be interested in testing their partners prior to receptive anal intercourse as a harm- reduction approach?

4. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University Study Design Stage 1: Hypothetical use

5. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University Study Design Methods  CASI & unassisted HIV rapid self-test at baseline  16 test kits given to participants for use over 3 months  24-hour hotline run by 2 senior clinical psychologists  Weekly reports on use through phone reporting system  In-depth interview at 3 month follow-up visit Sample  27 men (33% African American, 19% Latino, 41% White, 7% other; age range, 18 to 58 ) Stage 2: Actual use

6. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University Home Test Use Over 3-month Period  124 partners were asked to use HT  101 agreed  23 refused  Partner resistance to HT was seen as a sign not to have UAI  Proposing HT use led 2 partners to disclose seropositivity  Mutual testing often took place Results  10 tested individuals had positive results  7 were prospective partners, 3 acquaintances  6 were unaware of positive status  No UAI occurred when a partner was HIV-infected  Partners were verbally aggressive on 7 occasions (of 124) but no violence ensued.

7. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University Conclusions Rapid HIV Home Testing …  is highly acceptable among high-risk MSM  can identify previously undetected cases of HIV infection  can prevent potential HIV transmission  allows users to modify their sexual behavior to decrease their own risk of HIV infection  can increase frequency of HIV testing in high-risk MSM  may become an important harm reduction technology  can reach network members who do not access the healthcare system

8. HIV CENTER for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University Conclusions