(P164) COST AND COST-EFFECTIVENESS OF ONLINE RECRUITMENT STRATEGIES TO INCREASE HIV SELF-TESTING AMONG BLACK AND HISPANIC/LATINO MEN WHO HAVE SEX WITH MEN IN THE UNITED STATES, 2020-2021

Background:
Diagnosing HIV as early as possible is key to preventing new infections. Black or African American and Hispanic or Latino gay, bisexual, and other men who have sex with men (BMSM and HLMSM) in the United States are disproportionately affected by HIV. Providing HIV self-tests (HIVSTs) is a feasible strategy to increase testing. We analyzed the cost and cost-effectiveness of online recruitment strategies for enrolling BMSM and HLMSM into an HIV self-testing study.

Methods:
Participants aged ≥18 years without previous HIV diagnosis or current pre-exposure prophylaxis use were recruited through two recruitment strategies: online dating and general interest websites/apps (sites), from 11 US states (2020-2021). Using the health care provider’s perspective, we assessed four-month economic costs (2022 US Dollars) of implementing the recruitment and testing strategies, including: recruitment, administration and overhead, HIVST distribution, and shipping and handling. We analyzed cost-effectiveness of the recruitment strategies for the following outcomes: incremental cost per person tested and cost per new diagnosis.

Results:
Overall, 1906 men were enrolled either through the dating (n=1306) or general interest (n=600) sites. Dating sites costs were $275,776 to enroll, provide HIVST, and support 1005 MSM who used an HIVST, with 118 positive results (11.74% positivity). General interest sites costs were $168,099 to enroll, provide HIVST, and support 511 MSM who used an HIVST, with 28 positive results (5.48% positivity). Recruitment via dating compared to general interest sites was more costly, however more effective, with incremental cost-effectiveness ratios of $218/HIVST used and $1,196/positive diagnosis.

Conclusion:
Recruiting BMSM and HLMSM via online sites is an effective approach to providing HIVSTs to persons with undiagnosed infections. Recruitment via dating sites resulted in more men tested and new HIV diagnoses, and has the potential to be a cost-effective recruitment strategy for increasing awareness of HIV among these populations.