The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi.
<h4>Background</h4>Although HIV testing and counseling (HTC) uptake has increased dramatically in Africa, facility-based services are unlikely to ever meet ongoing need to the full. A major constraint in scaling up community and home-based HTC services is the unacceptability of receiving...
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Public Library of Science (PLoS)
2011-10-01
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| Series: | PLoS Medicine |
| Online Access: | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1001102&type=printable |
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| author | Augustine Talumba Choko Nicola Desmond Emily L Webb Kondwani Chavula Sue Napierala-Mavedzenge Charlotte A Gaydos Simon D Makombe Treza Chunda S Bertel Squire Neil French Victor Mwapasa Elizabeth L Corbett |
| author_facet | Augustine Talumba Choko Nicola Desmond Emily L Webb Kondwani Chavula Sue Napierala-Mavedzenge Charlotte A Gaydos Simon D Makombe Treza Chunda S Bertel Squire Neil French Victor Mwapasa Elizabeth L Corbett |
| author_sort | Augustine Talumba Choko |
| collection | DOAJ |
| description | <h4>Background</h4>Although HIV testing and counseling (HTC) uptake has increased dramatically in Africa, facility-based services are unlikely to ever meet ongoing need to the full. A major constraint in scaling up community and home-based HTC services is the unacceptability of receiving HTC from a provider known personally to prospective clients. We investigated the potential of supervised oral HIV self-testing from this perspective.<h4>Methods and findings</h4>Adult members of 60 households and 72 members of community peer groups in urban Blantyre, Malawi, were selected using population-weighted random cluster sampling. Participants were offered self-testing plus confirmatory HTC (parallel testing with two rapid finger-prick blood tests), standard HTC alone, or no testing. 283 (95.6%) of 298 selected adults participated, including 136 (48.0%) men. 175 (61.8%) had previously tested (19 known HIV positive), although only 64 (21.5%) within the last year. HIV prevalence was 18.5%. Among 260 (91.9%) who opted to self-test after brief demonstration and illustrated instructions, accuracy was 99.2% (two false negatives). Although 98.5% rated the test "not hard at all to do," 10.0% made minor procedural errors, and 10.0% required extra help. Most participants indicated willingness to accept self-test kits, but not HTC, from a neighbor (acceptability 94.5% versus 46.8%, p = 0.001).<h4>Conclusions</h4>Oral supervised self-testing was highly acceptable and accurate, although minor errors and need for supervisory support were common. This novel option has potential for high uptake at local community level if it can be supervised and safely linked to counseling and care. |
| format | Article |
| id | doaj-art-e162167b06f44f1a944b91d4847878a2 |
| institution | OA Journals |
| issn | 1549-1277 1549-1676 |
| language | English |
| publishDate | 2011-10-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj-art-e162167b06f44f1a944b91d4847878a22025-08-20T02:22:37ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762011-10-01810e100110210.1371/journal.pmed.1001102The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi.Augustine Talumba ChokoNicola DesmondEmily L WebbKondwani ChavulaSue Napierala-MavedzengeCharlotte A GaydosSimon D MakombeTreza ChundaS Bertel SquireNeil FrenchVictor MwapasaElizabeth L Corbett<h4>Background</h4>Although HIV testing and counseling (HTC) uptake has increased dramatically in Africa, facility-based services are unlikely to ever meet ongoing need to the full. A major constraint in scaling up community and home-based HTC services is the unacceptability of receiving HTC from a provider known personally to prospective clients. We investigated the potential of supervised oral HIV self-testing from this perspective.<h4>Methods and findings</h4>Adult members of 60 households and 72 members of community peer groups in urban Blantyre, Malawi, were selected using population-weighted random cluster sampling. Participants were offered self-testing plus confirmatory HTC (parallel testing with two rapid finger-prick blood tests), standard HTC alone, or no testing. 283 (95.6%) of 298 selected adults participated, including 136 (48.0%) men. 175 (61.8%) had previously tested (19 known HIV positive), although only 64 (21.5%) within the last year. HIV prevalence was 18.5%. Among 260 (91.9%) who opted to self-test after brief demonstration and illustrated instructions, accuracy was 99.2% (two false negatives). Although 98.5% rated the test "not hard at all to do," 10.0% made minor procedural errors, and 10.0% required extra help. Most participants indicated willingness to accept self-test kits, but not HTC, from a neighbor (acceptability 94.5% versus 46.8%, p = 0.001).<h4>Conclusions</h4>Oral supervised self-testing was highly acceptable and accurate, although minor errors and need for supervisory support were common. This novel option has potential for high uptake at local community level if it can be supervised and safely linked to counseling and care.https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1001102&type=printable |
| spellingShingle | Augustine Talumba Choko Nicola Desmond Emily L Webb Kondwani Chavula Sue Napierala-Mavedzenge Charlotte A Gaydos Simon D Makombe Treza Chunda S Bertel Squire Neil French Victor Mwapasa Elizabeth L Corbett The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi. PLoS Medicine |
| title | The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi. |
| title_full | The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi. |
| title_fullStr | The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi. |
| title_full_unstemmed | The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi. |
| title_short | The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: a cross-sectional feasibility study in Blantyre, Malawi. |
| title_sort | uptake and accuracy of oral kits for hiv self testing in high hiv prevalence setting a cross sectional feasibility study in blantyre malawi |
| url | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1001102&type=printable |
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