Advances in antiretroviral treatment enable persons with human immunodeficiency virus (HIV) infection to live a normal lifespan, as long as they know that they are infected and adhere to treatment. Treatment that leads to an undetectable viral load prevents transmission of HIV to others. Since 2013, however, the rate of new HIV diagnoses in the United States has stabilized, not decreased. Continued viral transmission occurs from persons unaware of their HIV status, or not receiving effective treatment. To end the AIDS epidemic, what strategies can be used to increase the rate of early diagnosis and treatment?¹

In this issue of JAMA Internal Medicine, MacGowan and colleagues report the findings of the eSTAMP study,² a Centers for Disease Control–sponsored randomized clinical trial that evaluated the effects of providing free HIV self-tests on the frequency of testing, diagnoses of HIV infection, and sexual risk behaviors. The study focused on a population at high risk of acquiring HIV, men who have sex with men, and recruited participants through the internet. Compared with the control group, the intervention group (which received HIV self-tests) had significantly more testing, and newly identified HIV infections. In addition, there were 34 newly identified HIV infections in social network members of participants who used the self-tests. The study demonstrated that self-testing facilitates HIV testing in a high-risk population when tests are free and convenient; distribution of self-testing kits to social contacts via social networks provides another avenue for making testing more accessible and acceptable.