At-Home HIV/STI Testing Pilot with Simple HealthKit

Communicable Disease Harm Reduction Section collaborated with Simple HealthKit to offer free HIV, syphilis, gonorrhea, chlamydia, and trichomoniasis testing to Wisconsin residents over 18 from August 25, 2023, to October 20, 2023. The aim was to make HIV and STI testing more accessible to those without nearby testing sites and increase awareness of one's status for prompt treatment. The $50,000 budget pilot project was funded using income from the AIDS Drug Assistance Program and CDC STI Disease Intervention Specialist Supplemental grant funds. Simple HealthKit managed an online portal for residents to order tests, including various testing options like HIV-1/2/Syphilis Combo and Chlamydia/Gonorrhea/Trichomoniasis tests using provided materials and instructions.

• HIV/STI testing
• Simple HealthKit
• Wisconsin residents
• Communicable Disease
• Harm Reduction

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1. At-Home HIV/STI Testing Pilot with Simple HealthKit Jacob Dougherty, HIV Prevention Unit Supervisor Communicable Disease Harm Reduction Section

2. Overview Communicable Disease Harm Reduction Section partnered with Simple HealthKit to provide free HIV, syphilis, gonorrhea, chlamydia, and trichomoniasis testing to Wisconsin residents over 18 Pilot lasted from August 25, 2023 October 20, 2023 2

3. Purpose of At-Home HIV/STI Self-Testing Make HIV and STI (chlamydia, gonorrhea, syphilis) testing widely available and more accessible to people who do not live near a free testing site or local health department or who are uncomfortable going to an existing testing site 3

4. Purpose of At-Home HIV/STI Self-Testing Increase number of people who know their status and access treatment Offer an option for testing in spaces with limited time for interaction with clients 4

5. Project Description Pilot Project $50,000 budget Simplified bid process to choose vendor Funded using income from AIDS Drug Assistance Program and CDC STI Disease Intervention Specialist Supplemental grant funds 5

6. Vendor: Simple HealthKit Simple HealthKit chosen as vendor through simplified bid process https://www.simplehealthkit.com/ 6

7. Project Expectations Simple HealthKit will manage a secure online portal where Wisconsin residents can order HIV/STI tests that meet their needs 7

8. Project Expectations Testing options: HIV-1/2/Syphilis Combo (dry blood spot) Chlamydia/Gonorrhea/Trichomoniasis (urine, rectal swab, throat swab) All samples are collected by the person who orders the test, and materials and instructions are provided by Simple HealthKit 8

9. Project Expectations Any Wisconsin resident, regardless of risk, can order one complete set of tests at no cost once every six months Simple HealthKit will verify that the shipping address is a legitimate Wisconsin address and monitor names of people who order tests 9

10. Project Expectations Simple HealthKit will share test results directly with the person who ordered the tests after the results have been processed by their lab via a HIPAA-compliant secure online portal 10

11. Project Expectations Simple HealthKit will share test results with Wisconsin DHS, and positive results will be followed up by either supplemental Disease Intervention Specialists (DIS) or Partner Services (HIV) Simple HealthKit will bill DHS for all program- related costs at least monthly 11

12. 12

13. Advertising and Promotion Google Paid Search Ads (8/25 9/24) DHS Website GovDelivery Distribution Word of Mouth QR Code on Flyers 13

14. Cost and Distribution Test Type Test Type Cost Per Test Cost Per Test Number Number Ordered Ordered % % Distributed Distributed Total Spent Total Spent Duo STD Test (HIV/Syphilis) $75.51 10 2.8% $755.10 Common Multi-Site STD Test (Gonorrhea/Chlamydia/Trich) $107.45 65 18% $6,984.25 Expanded Multi-Site STD Test (Gonorrhea/Chlamydia/Trich/ HIV/Syphilis) $148.47 286 79.2% $42,462.42 Total 361 $50,201.77 14

15. Total Tests Ordered Total Samples Returned and Processed Return Rate Total People Tested Results Opened Chlamydia Positives Gonorrhea Positives HIV Reactives Syphilis Reactives Trichomoniasis Positives Inconclusive/Invalid Tests 361 178 45.76% 170 97.19% 13 (Oral=1, Rectal=4, Urine=8) 3 (Oral=1, Rectal=1, Urine=1) 0 1 (Previously Identified) 3 4 15

16. Demographics- Gender Simple HealthKit utilization utilization was highest among people who identified as cis female highest All Other Genders 45% Cis cis female Female 55% 16

17. Demographics- Race Asian 4% Unknown/ Other11% Black 14% Simple HealthKit utilization utilization was highest highest among people who identify as white white White 71% 17

18. Demographics- Ethnicity Unknown 7% Hispanic/ Latino 10% Simple HealthKit utilization utilization was highest highest among people who identify as non non- -Hispanic Hispanic Non-Hispanic 83% 18

19. Numbers of Kits Distributed by ZIP Code 19

20. How did You hear about this? 54 Responses Health Clinic: 3 Local/Tribal Health Department: 2 Social Media: 10 Wisconsin DHS Website: 14 Other: 25 Research, Shelter Board, Google (9), I looked up information, Friend told me about it, Web, I work at a local health department 20

21. Measures of Success High rate of samples returned and processed (>75%) High rate of users who received and viewed their results (>95%) Equitable reach to underserved areas Smooth process to report results, link to treatment or confirmatory testing 21

22. Whats Next? Partnerships with Local Health Departments Public Health Vending Machines Distribution at Events Renewal of Online At-Home Self-Testing Based on Availability of Grant Funds 22

23. Questions? Thank you! 23