Men Who Have Sex with Men Seek Timely Human Immunodeficiency Virus Confirmation and Care after Rapid Human Immunodeficiency Virus Self-Test: Data from Partner Services Program, New York City

Background: The rapid human immunodeficiency virus (HIV) self-test in the United States has expanded opportunities for HIV testing in non-clinical settingswhichmay increase early diagnosis of HIVinfection. However, broad application may be limited by the cost of the test and concerns that self-testers who test positive will not seek timely HIV care. Methods: We used data from HIV partner services program to compare the sociodemographic characteristics, transmission risk, and clinical stage of persons diagnosed with HIV by report of rapid self-test. Among self-tested persons, we assessed timeliness of seeking definitive testing after self-test and linkage to care. Results: From January 2013 to August 2016, 8032 HIV-positive persons were interviewed. Compared with the 7905 persons who did not self-test, self-tested persons were significantly (all P = < 0.0001) male (96% vs 78%), white/non-Hispanic (46% vs 16%), men who have sex with men (92% vs 58%), college educated (67% vs 35%), and residing in medium-high income NYC neighborhoods (51% vs 44%). Higher proportions of selftested (91%) than non-self-tested persons (81%) linked to care within three months of diagnosis. Significantly (P = < 0.0001) more persons that self-tested positive (39/44, 89%) than persons that self-tested negative (14/36, 39%) sought laboratory-based HIV test within 1 month of last self-testing; and negative than positive self-tested persons were diagnosed with acute HIV infection (44% vs. 9%, P = < 0.0001). Conclusions: Our findings suggest that men who have sex with men sought timely HIV confirmatory testing and linkage to care after selftest. However, the cost of self-test kit may be an important barrier to its wide adoption across sociodemographic groups.