To make mailed HIV/STI testing most efficient for public health, we created the following strategy:
1) Centralized system for HIV/STI test kit ordering and distribution
We have developed a centralized HIV/STI test kit-ordering and fulfillment system. Public health agencies who opt in to using the system can choose the type and numbers of mailed tests, the duration of their participation, and the eligible populations they would like to target.
2) Testing options
Users will be sent an HIV oral rapid in-home test, with detailed instructions and information about confirmatory testing and HIV and STI prevention and care resources. We are expanding the options to include STI testing swabs and HIV dried blood spot testing, which users can send to a laboratory in the postage-paid return packet that will be included. For participants using PrEP, we are also adding a PrEP panel option, which includes HIV dried blood spot and creatinine testing.
Dating apps will promote this opportunity through messaging and advertisements. New jurisdictions will get a minimum of 2 messages per month for the first 4 months of participation. Users of geospatial social networking apps, like Grindr, can order by clicking on a link embedded within HIV-related content of their apps. Public health agencies can also include the ordering links in their other health promotion materials.
4) Results delivery
Users of the OraQuick self-administered swab will get their results at home. In the near future, we will also offer laboratory HIV and STI testing.
When STI testing is available and users select it, they will be able to access results of laboratory-based testing of self-collected specimens using a secure self-service results portal. Users with positive test results will get follow-up through their local jurisdiction, as well as links to geo-targeted testing and care services. All users will receive basic information about STI testing, PrEP, condoms, and U=U. All positive results for tests with required reporting will be automatically reported to the health department.