COVID-19 showed the benefits of at-home testing. A new partnership is expanding access to HIV testing kits

Three Philadelphia community groups are joining forces to apply the COVID-19 pandemic’s lessons about the utility of at-home medical testing to HIV, a disease that has long presented its own challenges to screening efforts.

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Bebashi Transition to Hope, a nonprofit founded to serve people of color living with HIV, is collaborating with two grassroots organizations to distribute HIV self-testing kits to vulnerable populations in Philadelphia.

Also involved are SistaTalkPHL, which serves single Black women, and Ark of Safety LGBTQ+ Safe Haven, focused on members of the LGBTQ community who are experiencing homelessness.

Together, the groups aim to expand HIV testing options to people who might have been reluctant to seek out testing through in-person visits to health clinics.

The partnership has the potential to be “a game-changer,” Adam McNeil, founder of SistaTalkPHL, said in a news release announcing the effort earlier this month.

When people living with HIV are treated, many can expect to feel healthy for years. Treatment also reduces their chances of transmitting the virus, especially through sex, according to the Centers for Disease Control and Prevention.

Barriers to testing include lack of access, an inability to take time off work, and lack of information about where to find care. And with HIV, people may not want to be seen at a testing site.

Additionally, some people at high risk of acquiring HIV, such as sex workers and people who inject drugs, might distrust authorities, including those in health care.

HIV is a sexually transmitted disease most prevalent among men who have sex with men. In recent years, Black and Hispanic Philadelphians were newly diagnosed with HIV at rates three times higher than white Philadelphians. The city also has also seen an increase in new diagnoses related to injection drug use.

The main challenge to ending the HIV epidemic is identifying people who are unaware of their status and connecting them with care, said Harsha Thirumurthy, a professor in the department of medical ethics and health policy at the University of Pennsylvania.

About 1,700 people in Philadelphia have an HIV infection but don’t realize it, according to a 2020 estimate by the city’s Department of Public Health. That number might be even higher because the HIV testing declined early in the pandemic, leading to low number of new diagnoses in 2020.

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Because self-testing can be done in the privacy of one’s home, “it can be seen as one way to close the gap,” Thirumurthy said.

At-home HIV tests have been approved by the Food and Drug Administration since 2012. Multiple studies found them to be accurate and effective at identifying people who acquired HIV.

The test itself is very similar to a COVID-19 test. People need only to swab inside their mouths, then stick the swab into a tube with the test fluid. A result can be seen within 20 to 40 minutes.

The test detects antibodies for the virus. A positive result needs to be followed up with a confirmatory lab test.

The city’s health department has been mailing free HIV testing kits to people who order through phillykeeponloving.com. It also distributes kits through partner organizations.

By leveraging their existing community relationships, the Philadelphia groups hope their new partnership will reach more vulnerable people, who otherwise might remain unaware of their HIV status.

After a home test returns a positive result, it’s critical to make sure the person gets a lab test to confirm their status, then get treatment started, Thirumurthy said.

That’s where the new grassroots partnership hopes to really make a difference.

Bebashi will use funding from the CDC to purchase the tests, then distribute about 50 or 60 kits each month to SistaTalkPHL and Ark of Safety, said Nafisah Houston, director of programs at Bebashi. The organizations will then give out the tests through their networks.

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Over the pandemic, Bebashi began offering self-testing, Houston said. They followed up with individuals to ask them about their test result and invited them to come to Bebashi’s wellness clinic for further testing and care as needed.

“It allowed us to have follow up with people who were testing privately at home,” she said.

The same protocol will be used more broadly through the new partnership. People who received testing kits will get a follow-up call and will be offered health care services, regardless of whether the test result was positive or negative.