Mailout HIV self-testing: overview of the GetaKit initiative in Ottawa, Canada


BACKGROUND: Access to HIV testing and sexual health resources has been limited in Ontario as a result of the province's COVID-19 response. However, people continue to engage in sexual contact with new partners, presenting an ongoing risk of HIV transmission and a continued need for HIV testing. To address this gap, a team of nurses at the University of Ottawa and Ottawa Public Health, in collaboration with staff from Ottawa ASOs and the OTHN, launched a mail-out HIV self-testing project entitled 'GetaKit'.
DESCRIPTION: GetaKit sought to assess the outcomes associated with an Internet-based ordering system of an HIV self-test kit in Ottawa, Canada, including HIV diagnosis rates and linkage to care. As of July 20, 2020, eligible participants ('¥18 years old, HIV-negative, not on PrEP, not in a HIV vaccine trial, living in Ottawa, no bleeding disorders) could register via to order kits. GetaKit utilised a status-neutral approach to testing, providing counselling to all clients and linking clients with the appropriate care, either confirmatory testing and treatment or prevention (PrEP).
LESSONS LEARNED: As of December 2020, 825 persons completed the eligibility screener; 63.9% (n=527) were eligible. Of eligible participants, 275 completed baseline surveys and 259 ordered a test. Approximately 26% (n=68) of participants had no prior HIV testing or were unsure of testing history. Approximately 66% (n=171) of participants belonged to a priority group for HIV testing, including members of gbMSM, Black, and Indigenous populations. We have results for approximately 70% (n=182) of participants who ordered a kit: none were positive, 143 were negative, 36 were invalid, and 2 'preferred not to say'. 61.3% (n=159) patients were referred for PrEP.
CONCLUSIONS: Our results indicated the effectiveness and acceptability of a mail-out HIV self-test kit in Ottawa, Canada. HIV self-testing ensured testing and prevention among regular and new testers while other sexual health resources were closed. Mailout HIV self-testing has the potential to increase access to HIV testing in Ontario.