Together takemehome: achieving scale and improving access to mailed HIV self-testing for key US populations - emory university, collaboration with building healthy online communities, signal group,…

Together takemehome: achieving scale and improving access to mailed HIV self-testing for key US populations - emory university, collaboration with building healthy online communities, signal group, orasure technologies, and nastad propose a program that will use an iterative improvement process to optimize our existing web-based ordering and fulfillment systems and integrate with CDC's let's end HIV together marketing campaigns to provide at least 875,000 and up to 1 million mailed HIV self-tests over the 5 year program with a focus on key US populations, including MSM, transgender women, black or african american cisgender women, and other residents of phase 1 EHE areas. The overarching public health goal of the program is to increase awareness of HIV status and improve utilization of other HIV prevention and care services leading to improved health and reduction in HIV transmission among US populations disproportionately affected by HIV. The specific short term outcomes from the program are: 1) culturally appropriate imagery and information developed by CDC available on the self-test ordering portal; 2) fully functional comprehensive hivst distribution program for procurement, storage, processing of orders and program monitoring; 3) increased access to HIV self-tests and prevention services including prep and STI testing among persons disproportionately affected by HIV; 4) increased understanding of strategies to successfully deliver HIV self-tests to populations disproportionately affected by HIV; and 5) increased understanding of user experience for HIV self-testing among populations disproportionately affected by HIV. There are also intermediate term outcomes from the program: 1) increased HIV testing among populations disproportionately affected by HIV and 2) increased new HIV diagnoses among populations disproportionately affected by HIV. The together takemehome (ttmh) program is the national scale-up of our existing takemehome program that focuses on providing infrastructure for state/local health departments to engage in mailed hivst distribution for their residents. This state/local program was the basis for the nationwide ttmh demonstration project, which will be refined and relaunched for the scale-up program. The program implementation model involves collaborating with CDC to implement refinements to our systems and materials and implement marketing efforts to refer key populations to the ttmh web-portal for ordering. These orders are automatically processed and sent to amazon fulfillment services. We will consistently communicate with participants on order status and send reminders for repeat ordering. In addition to self-service web-portal resources, trained staff will be available to provide referrals to HIV/STI care and prevention services, including provision of prep navigation. The program will be monitored and evaluated with data from multiple sources, including order information, web-traffic/referral tracking, surveys, and qualitative interviews. To optimize program outcomes, iterative improvements will be made to the ttmh systems and materials and provide timely information to CDC for refinement of their marketing efforts.