HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults

Abstract Background HIV Self-Testing (HIVST) is universally accepted as an innovative strategy complimenting existing HIV testing services to archive the UNAIDS, 95-95-95 goals by 2030. However, the adoption of HIVST is lagging in most sub-Saharan countries, including Tanzania. This study aimed to determine the level of knowledge, acceptability, and willingness to use HIVST among Medical students in Kilimanjaro region, Tanzania. Methods A descriptive cross-sectional study using a self-administered, semi-structured questionnaire was conducted from May to June 2019 among 271 medical students aged 18–44 years enrolled in a degree of Medicine course at Kilimanjaro Christian Medical University College. Results A total of 271 participants were enrolled (response rate of 100%). The mean age was 23.9 (SD 2.9), the majority (91%) were Christians, being single (92%), and a half (50.2%) were males. More than half (55.7%) was sexually active, 67.5% reported the age of first sexual debut at 19 years and above. The majority (81.5%) reported that they had one sexual partner, 37% used condoms during the last sexual act. The majority (98.7%) had never had a sexually transmitted disease during the past 3 months, 22.5% reported using alcohol when having sex. More than three-quarters (79%) ever tested for HIV, and 41.6% tested for HIV in the past year. More than two-thirds (67.9%) had a high level of knowledge on oral fluid HIV self-test. Being a female was related with high level of knowledge (P = 0.225). The acceptability of HIVST was 62.7%, and about two-thirds showed a willingness to buy a self-test kit if available for public use. Conclusions The high level of knowledge on oral fluid HIV self-testing, acceptability and willingness to buy self-test kit if available for public use among sexually active medical students underscores the importance of introducing HIVST as a complementary approach for existing HIV testing services in this setting. To make HIVST effective, interventionist should address concerns associated with self-testing, such as lack of pre and post-test counseling, suicidal risks after receiving HIV positive results, perceived risks of inaccurate HIVST test results, lack of linkage to care of individuals receiving HIV positive results, perceived risks of intimate partner violence, coercive testing of a female partner, and perceived high cost of buying self-test kits.

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Operationalizing the distribution of oral HIV self-testing kits to men who have sex with men (MSM) in a highly homophobic environment: the Nigerian experience

BMC Public Health ◽

10.1186/s12889-021-12378-0 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Adekemi Sekoni ◽

Waimar Tun ◽

Osasuyi Dirisu ◽

Temitope Ladi-Akinyemi ◽

Elizabeth Shoyemi ◽

...

Keyword(s):

Group Discussions ◽

The Sustainable Development ◽

Effective Strategies ◽

Qualitative Survey ◽

Self Testing ◽

Test Kit ◽

Community Skills ◽

Development Goals ◽

Self Test ◽

Sex With Men

Abstract Background Self-care health interventions are innovative approaches for improving health and achieving the sustainable development goals (SDGs). Men who have sex with men (MSM) have been disproportionately affected by Human Immunodeficiency Virus (HIV). In spite of this, stigma from healthcare workers has reportedly prevented MSM from accessing HIV testing in health facilities. This paper explored the operationalization of using key opinion leaders (KOLs) to distribute HIVST (HIV self-test) kits to MSM. This qualitative survey used a combination of in-depth interviews (IDI) with HIVST users and focus group discussions (FGDs) with KOLs to collect data three months after the distribution of the test kits by the KOLs. Thematic analysis of the data was carried out. Result Three themes were generated namely: KOLs serve as a trusted resource to promote and support HIVST for the MSM community; Skills and qualifications required for KOLs to effectively distribute and promote uptake of HIVST; and Effective strategies used to create demand and promote uptake of HIVST. Conclusion This study showed the practical steps involved in operationalizing KOL support system distribution of HIVST that positively influenced the testing experience for the participants irrespective of the HIV status and engagement in care. KOLs are a reliable resource to leverage for ensuring that HIV self-test kit is utilized and HIV positive individuals are linked to treatment and care in homophobic environments.

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The cost and intermediary cost-effectiveness of oral HIV self-test kit distribution across 11 distribution models in South Africa

BMJ Global Health ◽

10.1136/bmjgh-2021-005019 ◽

2021 ◽

Vol 6 (Suppl 4) ◽

pp. e005019

Author(s):

Katleho Matsimela ◽

Linda Alinafe Sande ◽

Cyprian Mostert ◽

Mohammed Majam ◽

Jane Phiri ◽

...

Keyword(s):

South Africa ◽

People Living With Hiv ◽

Distribution Models ◽

Integration Model ◽

Sex Worker ◽

Time And Motion ◽

Self Testing ◽

Test Kit ◽

Self Test ◽

The Cost

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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AWARENESS AND WILLINGNESS TO PAY FOR HIV SELF-TEST AMONG MEN WHO HAVE SEX WITH MEN FROM METRO MANILA, PHILIPPINES

Malaysian Journal of Public Health Medicine ◽

10.37268/mjphm/vol.20/no.1/art.260 ◽

2020 ◽

Vol 20 (1) ◽

pp. 64-70

Author(s):

Samuel Brando Piamonte ◽

Rossana Ditangco

Keyword(s):

Willingness To Pay ◽

Voluntary Counseling And Testing ◽

Counseling And Testing ◽

Self Testing ◽

Hiv Test ◽

Test Kit ◽

Metro Manila ◽

Self Test ◽

Sex With Men ◽

Saliva Test

Self-testing is a new innovation in HIV testing where one can conduct an HIV test and interpret results discreetly. However, such is not yet available in the Philippine market. This formative study aims to identify the awareness of men who have sex with men (MSM) from Metro Manila, Philippines towards HIV self-testing (HIVST) as well as their willingness to pay for a self-test kit should it be available commercially. Two-hundred fifty MSM who received a non-reactive HIV screening test result from a community-based voluntary counseling and testing center were recruited. Results indicated that there were more respondents who have not heard yet about HIVST. The social media and the internet were the most prominent of source of awareness about it. Frequent testers and being exclusively or more attracted to the same sex are more likely to be aware of HIVST. Median price one is willing to pay is 500 Pesos (roughly 10 US Dollars) and preference for saliva test that blood was reported. Over-all, results implicate that efforts to inform MSM about HIVST should be initiated effectively. Should it be available, HIVST services can also be optimized if done through saliva test and are provided at low price.

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Relative effectiveness of social media, dating apps, and informational search sites in promoting Human Immunodeficiency Virus self-testing (Preprint)

10.2196/preprints.35648 ◽

2021 ◽

Author(s):

Chrysovalantis Stafylis ◽

Gabriella Vavala ◽

Qiao Qang ◽

Bethany McLeman ◽

Shea M Lemley ◽

...

Keyword(s):

Social Media ◽

Human Immunodeficiency Virus ◽

Hiv Testing ◽

Relative Effectiveness ◽

Dating Apps ◽

Self Testing ◽

Test Kit ◽

Immunodeficiency Virus ◽

Related Stigma ◽

Self Test

BACKGROUND Social media sites, dating applications (apps), and informational search sites have been used to reach individuals put at-risk for Human Immunodeficiency Virus (HIV) infection. However, it is not clear which type of site is the most efficient in promoting home HIV self-testing, given that the users of various platforms may have different characteristics that impact their readiness for HIV testing. OBJECTIVE Compare the relative effectiveness of three web-based platform types: social media sites, dating apps, and informational search sites in promoting HIV self-testing among minority men who have sex with men (MSM) put at increased risk of HIV infection. In addition, we assessed differences in characteristics between participants who engaged and did not engage in HIV testing. METHODS Culturally appropriate advertisements were placed on popular sites of three different platforms: social media (Facebook, Instagram, and Twitter), dating apps (Grindr, Jack’d, and Hornet), and informational search sites (Google, Yahoo, and Bing). Advertisements targeted young (18-30 years old) and minority (Black and/or Latinx) MSM at risk of HIV exposure. Recruitment occurred in 3 waves, with each wave running advertisements on 1 site on each platform type over the same period. Participants completed a baseline survey assessing sexual or injection use behavior, substance use including alcohol, psychological readiness to test, attitudes toward HIV testing and treatment, and HIV-related stigma. Participants received an electronic code to order a free home-based HIV self-test kit. Follow-up assessments were conducted to assess HIV self-test kit use and uptake of Pre-Exposure Prophylaxis (PrEP) at 14- and 60-days post enrollment. RESULTS In all, 271 participants were enrolled. Two-hundred and fifty-four participants were included in the final analysis. Among those 254, 177 (69.7%) ordered a home HIV self-test kit. Most of the self-test kits were ordered by participants enrolled from dating apps. Due to waves with low enrollment, between wave statistical comparisons were not feasible. Within wave comparison showed that Jack’d showed higher order rates (3.29 kits/day), compared to Instagram (0.34 kits/day), and Bing (0 kits/day). There was no association between self-test kit ordering and HIV-related stigma, perceptions about HIV testing and treatment, or mistrust of medical organizations. CONCLUSIONS Our findings show that use of popular dating apps might be an efficient way to promote HIV self-testing. CLINICALTRIAL This study was reviewed and approved by the University of California, Los Angeles, Institutional Review Board (IRB# 18-001580). The study was registered on ClinicalTrials.gov (NCT04155502) and on International Registered Report Identifier (IRRID): DERR1-10.2196/20417. INTERNATIONAL REGISTERED REPORT RR2-10.2196/20417

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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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The characteristics and risk factors of human papillomavirus infection: an outpatient population-based study in Changsha, Hunan

Scientific Reports ◽

10.1038/s41598-021-94635-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Bingsi Gao ◽

Yu-Ligh Liou ◽

Yang Yu ◽

Lingxiao Zou ◽

Waixing Li ◽

...

Keyword(s):

Risk Factors ◽

Protective Factor ◽

Hpv Infection ◽

Population Based ◽

Cross Sectional Study ◽

Categorical Variables ◽

Chi Square ◽

Cross Sectional ◽

Hpv Dna ◽

Test Kit

AbstractThis cross-sectional study investigated the characteristics of cervical HPV infection in Changsha area and explored the influence of Candida vaginitis on this infection. From 11 August 2017 to 11 September 2018, 12,628 outpatient participants ranged from 19 to 84 years old were enrolled and analyzed. HPV DNA was amplified and tested by HPV GenoArray Test Kit. The vaginal ecology was detected by microscopic and biochemistry examinations. The diagnosis of Candida vaginitis was based on microscopic examination (spores, and/or hypha) and biochemical testing (galactosidase) for vaginal discharge by experts. Statistical analyses were performed using SAS 9.4. Continuous and categorical variables were analyzed by t-tests and by Chi-square tests, respectively. HPV infection risk factors were analyzed using multivariate logistic regression. Of the total number of participants, 1753 were infected with HPV (13.88%). Females aged ≥ 40 to < 50 years constituted the largest population of HPV-infected females (31.26%). The top 5 HPV subtypes affecting this population of 1753 infected females were the following: HPV-52 (28.01%), HPV-58 (14.83%), CP8304 (11.47%), HPV-53 (10.84%), and HPV-39 (9.64%). Age (OR 1.01; 95% CI 1–1.01; P < 0.05) and alcohol consumption (OR 1.30; 95% CI 1.09–1.56; P < 0.01) were found to be risk factors for HPV infection. However, the presence of Candida in the vaginal flora was found to be a protective factor against HPV infection (OR 0.62; 95% CI 0.48–0.8; P < 0.001). Comparing with our previous study of 2016, we conclude that the subtype distribution of HPV infection is relatively constant in Changsha. Our data suggest a negative correlation between vaginal Candida and HPV, however, more radical HPV management is required in this area for perimenopausal women and those who regularly consume alcohol.

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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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