Are women more likely to self-test? A short report from an acceptability study of the HIV self-testing kit in South Africa

BackgroundCountries around the world seek innovative ways of closing their remaining gaps towards the target of 95% of people living with HIV (PLHIV) knowing their status by 2030. Offering kits allowing HIV self-testing (HIVST) in private might help close these gaps.MethodsWe analysed the cost, use and linkage to onward care of 11 HIVST kit distribution models alongside the Self-Testing AfRica Initiative’s distribution of 2.2 million HIVST kits in South Africa in 2018/2019. Outcomes were based on telephonic surveys of 4% of recipients; costs on a combination of micro-costing, time-and-motion and expenditure analysis. Costs were calculated from the provider perspective in 2019 US$, as incremental costs in integrated and full costs in standalone models.ResultsHIV positivity among kit recipients was 4%–23%, with most models achieving 5%–6%. Linkage to confirmatory testing and antiretroviral therapy (ART) initiation for those screening positive was 19%–78% and 2%–72% across models. Average costs per HIVST kit distributed varied between $4.87 (sex worker model) and $18.07 (mobile integration model), with differences largely driven by kit volumes. HIVST kit costs (at $2.88 per kit) and personnel costs were the largest cost items throughout. Average costs per outcome increased along the care cascade, with the sex worker network model being the most cost-effective model across metrics used (cost per kit distributed/recipient screening positive/confirmed positive/initiating ART). Cost per person confirmed positive for HIVST was higher than standard HIV testing.ConclusionHIV self-test distribution models in South Africa varied widely along four characteristics: distribution volume, HIV positivity, linkage to care and cost. Volume was highest in models that targeted public spaces with high footfall (flexible community, fixed point and transport hub distribution), followed by workplace models. Transport hub, workplace and sex worker models distributed kits in the least costly way. Distribution via index cases at facility as well as sex worker network distribution identified the highest number of PLHIV at lowest cost.

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Assessment of the Sedia HIV Self-Test Device: Usability and Performance in the Hands of Untrained Users in Johannesburg, South Africa

Diagnostics ◽

10.3390/diagnostics11101816 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1816

Author(s):

Mohammed Majam ◽

Naleni Rhagnath ◽

Vanessa Msolomba ◽

Leanne Singh ◽

Michael S. Urdea ◽

...

Keyword(s):

South Africa ◽

Diagnostic Testing ◽

Efficacy Analysis ◽

Usability Assessment ◽

Self Testing ◽

Novice Users ◽

Self Test ◽

And Performance ◽

Testing Algorithm ◽

Hiv 1

The prevalence of HIV across South Africa places a strain on testing facilities. The use of HIV self-testing (HIVST) devices has been identified as a strategy to ease the burden on these facilities. The usability and performance of the Asante HIV−1/2 Oral Self-Test (Asante) (Sedia Biosciences, Portland OR, USA) device by novice users was assessed and reported on, to inform for the implementation of such devices in South Africa and elsewhere. Convenience sampling was used. Participants used the Asante HIVST device and recorded their interpretation of their results. Participants’ interpretations were compared with those of trained professionals and, thereafter, verified using the rapid diagnostic testing algorithm. Out of the eligible participants, 410 of the 524 (78.2%) were between the ages of 18–35. The usability assessment indicates that 100% of participants used the HIVST device’s information leaflet. However, 19/524 (3.6%) of participants who yielded an invalid result due to critical errors were excluded from the primary efficacy analysis. The average usability score was 98.1%. The sensitivity and specificity results were, 94.7% and 99.8%, respectively. This study shows that the Asante HIV self-test, and similar devices, can be valuable in providing convenient HIV self-testing and immediately available results. To accommodate a greater number of inexperienced users, the instructions may need to be revised.

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Analytical Performance of the Exacto Test HIV Self-Test: A Cross-Sectional Field Study in the Democratic Republic of the Congo

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa554 ◽

2020 ◽

Vol 7 (12) ◽

Author(s):

Serge Tonen-Wolyec ◽

Jérémie Muwonga Masidi ◽

Luc Ferdinand Kamanga Lukusa ◽

Gaetan Nsiku Dikumbwa ◽

Angèle Sarassoro ◽

...

Keyword(s):

Field Study ◽

Democratic Republic ◽

Analytical Performance ◽

Viable Option ◽

Excellent Performance ◽

Cross Sectional ◽

Performance Sensitivity ◽

Self Testing ◽

Republic Of The Congo ◽

Self Test

Abstract The Democratic Republic of the Congo (DRC) has begun implementing HIV self-testing to boost the first “95” of the UNAIDS 95-95-95 targets by 2025. This study aims to assess the performance and usability of the Exacto Test HIV (Biosynex, Strasbourg, France) self-test in the lab and in the field. The Exacto Test HIV self-test demonstrated high virological performance (sensitivity, 99.6%; specificity, 100%) in the lab and in the field in the hand of untrained users (sensitivity, 100%; specificity, 98.9%). Taken together, the excellent performance and usability characteristics of the Exacto Test HIV (Biosynex) self-test make the kit a viable option for HIV self-testing in the DRC.

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How to activate students’ natural desire to test themselves

Cognitive Research Principles and Implications ◽

10.1186/s41235-019-0187-y ◽

2019 ◽

Vol 4 (1) ◽

Author(s):

Kalif E. Vaughn ◽

Nate Kornell

Keyword(s):

Retrieval Practice ◽

Study Phase ◽

Presentation Condition ◽

Self Testing ◽

Testing Experiment ◽

Self Test

Abstract Testing oneself (i.e., doing retrieval practice) is an effective way to study. We attempted to make learners choose to test themselves more often. In Experiment 1, participants were asked how they wanted to study and were given four options: retrieval with no hint (e.g., idea: ______), a two-letter hint (e.g., idea: s____r), a four-letter hint (e.g., idea: se__er), or a presentation trial (e.g., idea: seeker). They tested themselves on the majority of trials. In Experiment 2, when the hint options were removed, they chose restudy rather than pure test on the majority of trials. These findings show that people prefer self-testing over restudy as long as they can get the answer right on the test. However, we would not recommend hints if they impaired learning compared to pure testing. Experiment 3 showed that this was not the case; the three retrieval conditions from Experiment 1 led to equivalent amounts of learning, and all three outperformed the pure presentation condition. We used different materials in Experiment 4 and found that the hints made retrieval slightly less beneficial when the hints made it possible to guess the answers without thinking back to the study phase (e.g., whip: pu__sh). In summary, hints catalyzed people’s intuitive desire to self-test, without any downside for learning, thus making their self-regulated study more enjoyable and effective.

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Feasibility of Indirect Secondary Distribution of HIV Self-Test Kits via WeChat Among Men Who Have Sex with Men: A National Cross-Sectional Study in China (Preprint)

10.2196/preprints.28508 ◽

2021 ◽

Author(s):

Li Shangcao ◽

Jing Zhang ◽

Xiang Mao ◽

Tianyi Lu ◽

Yangyang Gao ◽

...

Keyword(s):

Social Media ◽

Online Survey ◽

Sexual Partners ◽

Cross Sectional ◽

Self Testing ◽

Hiv Test ◽

Condomless Anal Intercourse ◽

Secondary Distribution ◽

Self Test ◽

Sex With Men

BACKGROUND The use of HIV self-test (HST) kits is commonplace in key sexually active populations. The direct secondary distribution of HST kits (DSDHK) is effective in improving the uptake of HIV self-testing. However, there are concerns about various limitations of DSDHK, including limited geographic location, payment problems, and face-to-face interaction. OBJECTIVE We evaluated the feasibility and characteristics of the indirect secondary distribution of HST kits (ISDHK) via WeChat (distributing HST application links and follow-up HST kits to partners) among men who have sex with men (MSM). METHODS From October 2017 to September 2019, an HIV self-testing (HIVST) recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for HST kits (referred to as “index participants” [Ips]). All of the MSM participants were encouraged to distribute the HST application link to their friends and sexual partners (referred to as “Alters”) through their social networks. All Alters were further encouraged to continue to distribute the HST application link. All participants paid a deposit (USD 7), refundable upon completion of the questionnaire and uploading of the test result via an online survey system. RESULTS 2,263 MSM met the criteria and successfully applied for HST. Of these, 1,816 participants returned their HST test results, including 1,422 (88.3%) IPs and 394 (21.7%) Alters. Compared with the IPs, the Alters practiced more condomless anal intercourse (CAI), a higher proportion of them never previously had an HIV test, and they had a greater willingness to distribute HST kits to sexual partners (all p < 0.05). After controlling for age, education, and income, the Alters had a greater proportion of MSM who had never tested for HIV before (aOR = 1.29, 95% CI 1.00–1.68), were more willing to distribute the HST application link (aOR = 1.71, 95% CI 1.21–2.40), had a lower number of sexual partners (aOR = 0.71, 95% CI 0.57–0.90), and were less likely to search for sexual partners via online means (aOR = 0.78, 95% CI 0.60–1.02). In comparison, the rates of reactive HST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy (ART) were similar for IPs and Alters. CONCLUSIONS The ISDHK mode of distributing HST application links via social media is feasible among the MSM population. The ISDHK mode should be used to supplement the DSDHK mode in order to enable a greater proportion of the MSM population to know their HIV infection status.

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Short Report Control of Xiphinema in South Africa

Nematode Vectors of Plant Viruses ◽

10.1007/978-1-4684-0841-6_45 ◽

1975 ◽

pp. 449-449

Author(s):

P. C. Smith

Keyword(s):

South Africa ◽

Short Report

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Acceptability and correlates of HIV self-testing among university students in northern Nigeria

International Journal of STD & AIDS ◽

10.1177/0956462420920136 ◽

2020 ◽

Vol 31 (9) ◽

pp. 820-831

Author(s):

Zubairu Iliyasu ◽

Radeeyah B Kassim ◽

Bilkisu Z Iliyasu ◽

Taiwo G Amole ◽

Nafisa S Nass ◽

...

Keyword(s):

University Students ◽

Cross Sectional Study ◽

Consistent Condom ◽

Consistent Condom Use ◽

Cross Sectional ◽

Logistic Regression Models ◽

Program Of Study ◽

Self Testing ◽

Self Test ◽

Testing And Counseling

Concerns about stigma and confidentiality limit the uptake of HIV testing and counseling (HTC) among young adults. HIV self-testing has been offered as a youth-friendly alternative to conventional HTC. We conducted a cross-sectional study to assess HTC uptake, willingness to self-test, and their predictors among university students ( n = 399) in Kano, Nigeria. Anonymous self-administered questionnaires were provided to participants. Adjusted odd ratios were generated for predictors with logistic regression models. The results showed that only 35.8% ( n = 143) of participants had previous HTC.Most respondents (70.4%, n = 281) were willing to self-test. HTC was associated with year of college (500 Level vs. 100 Level), adjusted odds ratio (AOR, [95% Confidence Interval (CI)] = 0.44 (0.19–0.97), campus residence (off- vs. on-campus, AOR = 0.45; 95%CI: 0.28–0.73), sexual activity in the past six months (AOR = 0.39; 95%CI: 0.24–0.64), willingness to self-test (AOR = 0.38; 95%CI: 0.22–0.66), and consistent condom use (AOR = 4.45; 95%CI: 1.41–14.08). Students who were older (≥ 30 vs. <20 years, AOR = 0.20; 95%CI: 0.05–0.90) and female (AOR = 0.56; 95%CI: 0.32–0.98) were less likely to be willing to self-test, whereas students who were more senior (500 Level vs. 100 Level, AOR = 5.24; 95%CI: 1.85–14.84), enrolled in clinical science programs (vs. agriculture, AOR = 4.92; 95%CI: 1.51–16.05) or belonging to “other” ethnic groups (vs. Hausa–Fulani, AOR = 2.40; 95%CI: 1.11–5.19) were more willing to self-test. Overall HTC uptake was low, but acceptability of self-testing was high. College seniority, age, ethnicity, and program of study were associated with willingness to self-test. Our findings support the feasibility of scaling up HIV self-testing among university students in Nigeria.

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