ABSTRACT
Black and Latino men who have sex with men (BLMSM) in the US South have the highest HIV infection
rates in the country. Increasing HIV testing among men who have sex with men may decrease new HIV
infections in this population, yet rates of regular testing among BLMSM in the South are low. HIV self-testing
(HST), or the self-administration of an HIV screening device, is an effective strategy to increase HIV testing
among men whohave sex with men. However, HST implementation within health settings in the US South is
limited. One possible barrier to implementation is program planners’ limited knowledge of how BLMSM in the
South prefer to access HST and how much they would pay. For example, although home delivery and peer
delivery are two strategies that successfully increase HST use among BLMSM elsewhere in the US,
researchers have yet to determine which of these strategies BLMSM in the South prefer and their
corresponding willingness to pay for each strategy. In addition, little overall is known about facilitators and
barriers to initiating HST programs from the perspectives of implementation decisionmakers at public health
departments, HIV / STD testing clinics, andcommunity-based organizations in the US South. In this
predoctoral fellowship, I will conduct a discrete choice experiment among BLMSM (N=300) in several states
in the US South (Louisiana, Mississippi, Georgia, Florida) to elicit this population’s relative preferences for
several HST delivery strategies and an estimated dollar amount they would pay for each program. The
delivery strategies I will evaluate through the discrete choice experiment are retail purchase at drugstores,
home delivery, and peer delivery. I will also conduct semi-structured interviews (N=30) with HIV prevention
program decisionmakers at various health organizations serving BLMSM in the US South to understand
facilitators and barriers to HST implementation. By increasing the knowledge of HST implementation
outcomes from the perspectives of patients and providers, this project will build a roadmap for the initiation of
HST programs to decrease HIV incidence among one of the most disproportionately impacted populations in
the US.
