Factors Associated with Mobile App Ordering of HIV Self-test Kits and Reporting of Results Among Black People in Canada: Analysis of Data from “I’m Ready” National HIV Self-testing Implementation Study

Black people experience significant barriers to accessing facility-based HIV testing. HIV self-testing is an effective way to increase testing among populations with limited access to facility-based testing. However, the acceptance and uptake of HIV self-testing varies among different populations. The objective of this study was to examine the factors associated with the uptake of HIV self-testing kits and reporting of test results by Black people. The findings from this study will provide empirical evidence to inform the design of evidence-based strategies aimed at increasing HIV self-testing in Black communities in Canada. We analyzed data for Black participants in the 'I'm Ready' HIV self-teting implementation study to examine factors associated with the uptake of HIV self-test kits and reporting of test results. We used descriptive statistics (frequencies, proportions) to describe demographic characteristics and variables of interest, while bivariate and multivariable binary logistic regression was used to examine associations between demographic characteristics and ordering a kit and submitting a test result. Among the 14,071 participants who participated in the "I'm Ready" implementation study, 3,082 (22%) identified as Black. Among Black participants, the majority (51%) were 18-24 years and identified as cis-men (53%) or cis-women (43%). One in five participants identified as gay, bisexual or queer. Age (> 24 years) and gender (non-binary, Trans man/woman, gender queer and self-described gender) were associated with high likelihood of ordering a test kit. However, employment status (being self-employed or unemployed), precarious immigration status (refugee status, temporary work permit status and undocumented status), province or territory of residence, (living in British Columbia, Prairies, Atlantic provinces and the Territories), or living in small and medium sized communities and sexual risk behavior were all associated with less likelihood of ordering a test kit. Only Immigration status (undocumented status or refugee status) was associated with less likelihood of reporting of test results. Interventions to increase the uptake and reporting of HIV self-testing among Black people should explore ways to reach high-risk individuals, those with precarious employment or precarious immigration status, and those who live in small or medium sized communities in Canada.