Empowering Gender Diverse Communities: The Importance of HIV Self-Testing

In the mission to end the HIV epidemic in the U.S., HIV testing is the critical entry point to prevention and care services. However, there are structural barriers that can make these services inaccessible to transgender and nonbinary people, including stigma, racism, poverty, transphobia, and previous negative experiences trying to navigate health care settings.

HIV self-testing enables a person to learn their HIV status by placing control directly into the hands of individuals. With HIV self-tests, individuals can discreetly and conveniently test themselves in private, bypassing the potential discomfort or discrimination they might face in traditional settings.

Self-testing also addresses logistical barriers that may deter gender diverse individuals from seeking HIV testing, including transportation challenges, concerns about confidentiality, and concerns of discrimination.

The Together TakeMeHomeExit Disclaimer (TTMH) program aims to provide people with a convenient and discreet option for HIV testing. Launched in March 2023, the TTMH program mails free HIV self-tests to people in the United States, including Puerto Rico. People can order up to two free HIV self-tests every 90 days via the program’s online portal. Tests are available to people 17 years or older, regardless of health insurance or immigration status. TTMH is funded by CDC under award number 1NU62PS924790 and is implemented through partnership and collaboration with Emory University, Building Healthy Online Communities (BHOC), NASTAD, Signal Group, and OraSure Technologies.

As we mark the one-year anniversary since program launch, we have been delighted to see the strong engagement and use of the program, including people who identify as transgender or gender diverse.

To date the program has distributed over 450,000 tests with approximately 9% of tests ordered by persons who self-identified as gender diverse audiences in the post-order survey on the TTMH online website. Approximately 27% of gender diverse persons who ordered tests reported never having tested for HIV before ordering an HIV self-test, and 21% reported that they had last tested more than a year ago. This program reaches many populations, however by providing HIV self-tests to gender diverse persons the program is reaching a subset who are not successfully reached by other testing options.

If your organization works with transgender or other gender diverse persons and you are interested in helping to promote the campaign, please reach out to us at StopHIVTogether@cdc.gov for customized materials and tracking tools to measure your impact.

Join in raising awareness about HIV self-testing by downloading and sharing resources from CDC’s Together campaign, the national campaign of both the EHE initiative and the National HIV/AIDS Strategy. Together is an evidence-based campaign created in English and Spanish that aims to empower communities, partners, and health care providers to reduce HIV stigma and promote HIV testing, prevention, and treatment. You can also share social media content from CDC’s self-testing digital toolkit using the #HIVTestMyWay, #AutoPruebasDelVIH, and #StopHIVTogether hashtags. Together, we can work to address HIV disparities and enhance HIV testing efforts among people most affected by HIV.