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Peer-driven HIV prevention strategies can be effective in identifying high-risk persons with undiagnosed infections. Besides individual self-testing, other potential uses of rapid home HIV test kits include distributing them, and testing with others within one's social or sexual networks. We sought to identify factors associated with the willingness to engage in these alternative activities among men who have sex with men (MSM) in the United States. From May to October 2014, we surveyed 828 HIV-negative or unknown status MSM about multiple aspects of rapid home HIV testing. A greater proportion indicated being likely to distribute free oral fluid (OF) tests compared to free finger-stick blood (FSB) tests (91% versus 79%), and almost three-fourths (72%) reported being likely to test with their friends or sex partners in the future. MSM not identifying as homosexual/gay were less willing to distribute OF tests, and those with lower educational attainment were more willing to distribute FSB tests. MSM unaware of their HIV status were less likely to report potentially testing with others using free rapid home HIV tests compared to those who were HIV-negative. Finally, MSM willing to self-test were more likely to report future test kit distribution, and those willing to distribute kits were more likely to report potentially testing with others. Engaging individuals with positive attitudes towards these strategies in prevention efforts could help increase HIV testing levels among MSM. A greater understanding of the potential public health impact of rapid home HIV test kits is necessary. [ABSTRACT FROM PUBLISHER]

There is wide variation in reported risk factors for HIV incidence among injecting drug users by community. Available HIV seroprevalence and incidence data indicate that nearly 60% of HIV infection is associated with injecting drug use in Connecticut and 48% in Massachusetts. Using 12-month follow-up data on 354 initially HIV-negative New England (Massachusetts and Connecticut) methadone treatment clients, we assessed the association between baseline drug use practices, sexual behavior, partner behaviors, and client-reported HIV infection during follow-up. Variables that predicted client-reported positive HIV antibody test results were modeled by Cox proportional hazards regression. HIV infection among those tested was 14.2 per 100 person years (PY) [95% Confidence interval (CI) = 9.5 to 21.3]. For each injection the relative risk (RR) was 1.1 (95% CI = 1.1 to 1.2), for males 3.0 (95% CI = 1.2 to 7.3), for blacks 5.0 (95% CI = 1.6 to 15.5), for Hispanics 3.6 (95% CI = 1.2 to 10.5). Men who used more than one unclean needle per day and had an HIV-infected steady partner had an RR of 28.4 (95% CI = 4.4 to 176.4). For women, using speedball (RR = 6.1, 95% CI = 1.2 to 38.8) and being black (RR = 4.4, 95% CI = 1.0 to 19.8) predicted self-reported HIV infection; having a steady partner who ever injected increased this risk substantially (RR = 65.3, 95% CI = 4.0 to 1046.5). These findings for IDUs in Massachusetts and Connecticut indicate that risk factors for HIV infection for men are consistent with expected transmission by unclean needles with an HIV-infected partner, but a preference for using speedball predicted HIV infection among women IDUs. [ABSTRACT FROM AUTHOR]