Home Specimen Collection for Early Detection of HIV: Feasibility & Acceptability Among those at Risk

Objective: To assess the feasibility and acceptability of bimonthly home oral fluid (OF) and dried blood spot (DBS) collection for early detection of HIV infection among individuals at high risk.

Methods: Potential participants were randomly selected from four sites in the NIH/HIV Network for Prevention Trials (HIVNET) Vaccine Preparedness Study. Successive recruitment continued until a total of 241 participants (140 men who have sex with men (MSM), 72 injection drug users, and 29 women at heterosexual risk) accepted randomization to a six month study requiring home collection of bimonthly OF or DBS specimens. Participants could select telephone calls or clinic visits to receive HIV counseling and test results. The HIVNET central laboratory (CL) monitored receipt of bimonthly specimens and adequacy of specimens for testing. Acceptability of bimonthly home oral fluid and dried blood spot collection and telephone counseling was assessed in an end-of-study self-administered questionnaire.

Results: Among those approached, 84% agreed to be randomized to either OF or DBS collection; 95% of participants chose results disclosure and counseling by telephone. Overall, acceptance of home specimen collection and selection of telephone counseling did not differ by sex or risk behavior. The CL received 96% and 90% of expected OF and DBS specimens, respectively; 99% of each specimen type was adequate for testing. Most participants reported that OF (97%) and DBS (89%) specimen collection kits were easy to use; 85% reported that bimonthly testing did not make them worry more about HIV, and 98% judged that with bimonthly testing their risk behavior remained the same (77%) or became less risky (21%).

Conclusions: Bimonthly home specimen collection of both OF and DBS is feasible and acceptable among individuals at high risk. Participants clearly prefer telephone counseling to on-site counseling when bimonthly testing is required.

Freya Spielberg
6034 35th Avenue, NW
Seattle, WA 98107