SUPPLEMENT ARTICLE Preferences for Home-Based HIV Testing Among Heterosexuals at Increased Risk for HIV/AIDS: New Orleans, Louisiana, 2013 William T. Robinson, PhD,*† Meagan Zarwell, PhD,*‡ and DeAnn Gruber, PhD† Abstract: Participants in the New Orleans arm of the National HIV Behavioral Surveillance of Heterosexuals at Increased Risk for HIV were asked about potential utilization of self-administered home-based tests for HIV. The majority (86%) would use a free home-based test if provided by mail and 99% would seek treatment based on a positive result. In addition, more than half of respondents would return test results in some format to the test provider, whereas most of the remaining participants preferred to discuss results only with their doctor. These findings point toward a potential method for advancing the National HIV/AIDS Strategy. Key Words: HIV testing, National HIV behavioral surveillance, home-based testing (J Acquir Immune Defic Syndr 2017;75:S352–S356) INTRODUCTION Currently, there are over 1.2 million people living with HIV/AIDS in the United States and approximately 50,000 new infections are diagnosed each year. 1 In 2014, 24% of new infections were attributed to heterosexual activity. 1,2 Despite the high percentage of new infections associated with hetero- sexual activity, this risk group remains under represented and poorly defined in the literature leading the Centers for Disease Control and Prevention (CDC) to call for more research that seeks to engage individuals in testing and linkage to care. 3,4 The “Treatment as Prevention” approach and recent research has suggested that universal diagnosis, linkage to treatment, and adherence support among infected individuals with the goal of a reduction in viral load to nondetectable levels would result in a substantial impact on the current epidemic. 5–7 Despite efforts to increase and routinize testing, such as opt-out testing and testing in emergency departments, universal testing has yet to be realized. For example, while the estimated number of individuals living with HIV who are unaware of their infection has decreased from approx- imately 1 in 5 in 2010 to 1 in 8 in 2015, 1 many at risk individuals do not test routinely or have never been tested. It is estimated that more than half of American adults have never taken an HIV test. 8 Furthermore, significant barriers to HIV testing such as convenience, travel, costs, stigma, and desire for privacy exist especially for communities that have not been traditionally targeted for HIV testing and pre- vention efforts. 9–11 Self-administered or home-based HIV testing (HBT) may hold some promise to increase the prospect of universal testing among populations and other risk groups that may not test regularly including heterosexuals. Home- based HIV testing was first made available in 1996 and subsequently a number of studies have demonstrated its utility in global settings. For example, a recent systematic review and meta-analysis showed overwhelming accep- tance of HBT in 21 studies performed in sub-Saharan Africa. 12 The pooled proportion of individuals who accepted an HIV test in these studies was 83.3%, of which 99.6% received their test result. The US Food and Drug Administration has only recently approved the first home testing kit, which allows individuals to self-administer the test and interpret their own result, for use in the United States. 13,14 Some domestic studies have examined willingness and uptake of HBT 15–17 and some programs have been developed to make HBT more accessible within this population, including direct provision of HBT in nontraditional venues such as bath houses. 18 Most of these studies, however, have been conducted with communities of gay, bisexual, and other men who have sex with men. While home-based and self-testing strategies could potentially change the face of HIV prevention, 12,19,20 general uptake and acceptance of HBT among heterosexuals remains largely unknown. In one study based on a series of focus groups, Catania and others suggested that disseminating oral- HIV tests through pharmacies and social service venues may be a feasible strategy to reach African American youth; 21 however, this may only be true for free testing programs because they also found the expense of the test for purchase by individuals to be a possible barrier to wider uptake. 10,21,22 From the *Louisiana State University Health Sciences Center New Orleans, New Orleans, LA; †Louisiana Department of Health, Office of Public Health STD/ HIV Program, New Orleans, LA; and ‡Behavioral and Community Health Sciences Program, NO/AIDS Task Force, New Orleans, LA. Supported by the Grant or Cooperative Agreement Number 1U62PS005081- 01, funded by the Centers for Disease Control and Prevention. Portions of these results were presented at the American Public Health Association’s annual meeting; November 18, 2014; New Orleans, LA. The authors have no conflicts of interest to disclose. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. Correspondence to: William T. Robinson, PhD, LSU HSC School of Public Health, Behavioral and Community Health Sciences, 2020 Gravier Street, 3rd Floor, New Orleans, LA 70112 (e-mail: Billy.robinson@la.gov). Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. S352 | www.jaids.com J Acquir Immune Defic Syndr  Volume 75, Supplement 3, July 1, 2017 Copyright Ó 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.