Pilot Award

Transgender women are the population most impacted by HIV in the United States, with infection rates approximately 40 times higher than the general population. Despite elevated risk, the rates of HIV antibody testing in the transgender community are particularly low. Alternative testing strategies are critical for the approximately 700,000 transwomen living in the U.S. HIV self-testing kits will likely be available over-thecounter in 2012 and have enormous potential to increase testing uptake and earlier diagnosis of HIV infection, leading to improved health and decreased transmission. We will explore feasibility, acceptability, and supportive materials needed to offer home-based self-administered HIV testing for transwomen in three phases. Two focus groups will be conducted during a formative research phase to inform development of instructional materials to support reliable self-administered HIV testing and supplemental educational materials to be included in the home-test kits. The pilot study includes following 40 HIV-negative transwomen in San Francisco in a 3-monthstudy of home test kits. Rapid tests will be demonstrated at baseline; participants will self-test at home monthly and provide acceptability data at 1 and 3 months. At the third visit participants will perform the test in the presence of a clinician to evaluate adherence to instructions. The third post-pilot phase includes in-depth-interviews (IDIs) of 20 participants, and analysis of pilot study data. Analysis of acceptability and feasibility will include descriptive statistics as well as qualitative analysis of IDI data. This mixed-methods study undertaken by an early career PI (PhD 2009 / Assistant Professor 2011) represents the first attempt to systematically examine acceptability, feasibility, preferences, and support for home-based rapid HIV testing in the U.S. transfemale community.