Home collection versus publicly funded HIV testing in San Francisco: Who tests where?

We examined records of all HIV antibody tests performed at anonymous public ly funded (PF) sites and by home collection (HC) testing for residents of S an Francisco from August 1996 to December 1997. Although far fewer tests we re performed by HC testing than at PF sites (715 versus 8712, respectively) , a higher proportion of HC testers reported no prior history of HIV testin g (33.1% versus 17.9%). HIV seroprevalence was higher among PF rests (1.8%) than among HC tests (0.9%). Compared with PF testers, HC testers were less likely to be gay men, lesbian or bisexual women, heterosexual women, Afric an American, or Latino. HC testers were more likely to report sex with a kn own HIV-positive partner. HC testers were also more likely to reside in aff luent neighborhoods. HC testing reaches some high-risk persons who may not otherwise seek PF testing, although, overall, the risk profile of HC tester s appeared lower than that of PF testers. HC testing reaches some individua ls who can financially afford HC testing, thus saving public prevention res ources for hard-to-reach, high-risk populations.