J-103 Performance and usability of the OraQuick® HIV Self-test, an oral fluid based HIV self-test, in South Africa

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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Usability assessment of seven HIV self-test devices conducted with lay-users in Johannesburg, South Africa

PLoS ONE ◽

10.1371/journal.pone.0227198 ◽

2020 ◽

Vol 15 (1) ◽

pp. e0227198 ◽

Cited By ~ 3

Author(s):

Mohammed Majam ◽

Laura Mazzola ◽

Naleni Rhagnath ◽

Samanta T. Lalla-Edward ◽

Raees Mahomed ◽

...

Keyword(s):

South Africa ◽

Usability Assessment ◽

Self Test

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

AIDS Care ◽

10.1080/09540121.2016.1234687 ◽

2016 ◽

Vol 29 (3) ◽

pp. 339-343 ◽

Cited By ~ 8

Author(s):

Alexandra Spyrelis ◽

Saira Abdulla ◽

Sasha Frade ◽

Tessa Meyer ◽

Miriam Mhazo ◽

...

Keyword(s):

South Africa ◽

Short Report ◽

Self Testing ◽

Self Test

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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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