Mixed-Methods Evaluation of the Incorporation of Home Specimen Self-Collection Kits for Laboratory Testing in a Telehealth Program for HIV Pre-exposure Prophylaxis

• Type of Material: Article
• Authors: Emily E Chasco, University of Iowa; Angela B Hoth, University of Iowa; Hyunkeun Cho, University of Iowa; Cody Shafer, NuCara Pharm; Aaron Siegler, Emory University; Michael E Ohl, University of Iowa
• Language: English
• Date: 2021-03-19
• Publisher: SPRINGER/PLENUM PUBLISHERS
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021
• Final Published Version (URL): http://dx.doi.org/10.1007/s10461-021-03209-9
• Title of Journal or Parent Work: AIDS AND BEHAVIOR
• Volume: 25
• Issue: 8
• Start Page: 2463
• End Page: 2482
• Grant/Funding Information: The home kit initiative was supported by internal program funds at the University of Iowa, obtained through an award for innovation granted to Iowa TelePrEP by the American Academy of HIV Medicine.; The initiative was also supported in part by the National Institute of Mental Health (RO1MH114692) and by the Emory Center for AIDS Research (P30AI050409). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: Biomedical Social Sciences; Social Sciences; Public, Environmental & Occupational Health; Social Sciences, Biomedical; PrEP; Life Sciences & Biomedicine; Telehealth; Home-testing; Science & Technology; HIV prevention
• Research Categories: Psychology, Behavioral; Biology, Biostatistics; Health Sciences, Medicine and Surgery

Abstract

Home specimen self-collection kits with central laboratory testing may improve persistence with PrEP and enhance telehealth programs. We offered Iowa TelePrEP clients the choice of using a home kit or visiting a laboratory site for routine monitoring. Mixed-methods evaluation determined the proportion of clients who chose a kit, factors influencing choice, associations between kit use and completion of indicated laboratory monitoring, and user experience. About 46% (35/77) chose to use a kit. Compared to laboratory site use, kit use was associated with higher completion of extra-genital swabs (OR 6.33, 95% CI 1.20–33.51, for anorectal swabs), but lower completion of blood tests (OR 0.21, 95% CI 0.06–0.73 for creatinine). Factors influencing choice included self-efficacy to use kits, time/convenience, and privacy/confidentiality. Clients reported kit use was straight-forward but described challenges with finger prick blood collection. Telehealth PrEP programs should offer clients home kits and support clients with blood collection and kit completion.