African, Caribbean, or Black participants report lower levels of STI/HIV risk but equal or higher rates of STI/HIV diagnoses: The GetaKit.ca study

The COVID-19 pandemic and the HIV epidemic have both highlighted the need of race/ethnicity-based data to inform responses to infectious disease outbreaks. However, no such public health data exist in Canada. To generate some such data, we extracted data from the GetaKit.ca study, which is a website through which persons in Canada could obtain free HIV self-tests. We used data from April 1, 2021, to March 31, 2024. From 8,459 participants, of whom 16% ( n = 1240) identified as Black, we found that Black participants reported low levels of risk factors for STI/HIV acquisition. We also identified that Black compared to White participants reported lower rates of prior STI/HIV testing and prevention services, and lower overall rates of self-reported prior STI/HIV diagnoses, although this difference mainly only applied to prior chlamydia or gonorrhea infections among cis-male participants; there were no differences for the rates of self-reported prior syphilis infections (overall and in gay, bisexual, or other men who have sex with men) or chlamydia infections in cis women. Finally, diagnostic outcomes in the study identified nonsignificantly different rates of HIV diagnoses (from the HIV self-tests) but higher rates of chlamydia (from laboratory testing) among Black participants. These results highlight the need for more race/ethnicity-based data. They also suggest that current metrics of STI/HIV risk may not work well for Black populations.