Increasing HIV testing engagement through provision of home HIV self-testing kits for patients who decline testing in the emergency department: A pilot randomisation study

Anuj V. Patel, Samuel M. Abrams, Charlotte A. Gaydos, Mary Jett-Goheen, Carl A. Latkin, Richard E. Rothman, Yu Hsiang Hsieh

Research output: Contribution to journalArticle


Objective Up to 60% of patients decline routine HIV testing offer in US emergency departments (EDs). The objective of this study is to determine whether the provision of HIV self-testing (HIVST) kit would increase engagement of HIV testing among these HIV test ' €' Decliners'. Methods Patients who declined a test offered in an ED-based triage nurse-driven HIV screening programme were enrolled and randomised to either the HIVST or the control group. The patients in the HIVST group received HIVST kits to take home, were encouraged to report test results to an established internet-based STI/HIV testing recruitment website ' €' I Want the Kit' (IWTK) and received five referral cards for their peers to request HIVST kits from IWTK. The control group received pamphlets about publicly available HIV testing sites. HIV testing from both groups after enrolment was determined via telephone follow-up at 1 month. Testing rate ratio (RR) was determined using χ 2 tests. Results Fifty-two patients were randomised to the HIVST group and 48 to the control group. Among all 64 patients completing any follow-up, 14/29 (48%) patients in the HIVST group tested themselves at home with the provided kit. Four of these had never had an HIV test. Only 2/35 (6%) in the control group reported having an HIV test after enrolment (RR: 8.45 (95% CI: 2.09 to 34.17)). 57% (8/14) in the HIVST group reported test results to IWTK. Conclusion Provision of HIVST kits supplements ED-based screening programme and significantly improved engagement of HIV testing among those test ' €' Decliners' in the ED. Trial registration number NCT03021005, results.

Original languageEnglish (US)
Pages (from-to)358-360
Number of pages3
JournalSexually transmitted infections
Issue number5
StatePublished - Aug 1 2019



  • HIV
  • HIV testing
  • behavioural interventions
  • intervention studies
  • screening

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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