Progress on the scaling up of HIV testing in South Africa through varied distribution models using the oral HIV self‐test kit

Oral Diseases ◽  
2020 ◽  
Vol 26 (S1) ◽  
pp. 137-140
Author(s):  
Mohammed Majam
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Scaling Up ◽  
Distribution Models ◽  
Test Kit ◽  
Self Test ◽  
Varied Distribution

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

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.

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

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

scholarly journals Promoting HIV testing with home self-test kit among men who have sex with men in China: a feasibility study

The Lancet ◽  
2015 ◽  
Vol 386 ◽  
pp. S68 ◽  
Author(s):  
Xiaofang Wang ◽  
Zunyou Wu ◽  
Zhenzhu Tang ◽  
Quanxin Nong ◽  
Yanqi Li
Keyword(s):  
Hiv Testing ◽  
Feasibility Study ◽  
Test Kit ◽  
Self Test ◽  
Sex With Men

scholarly journals Understanding the Reasons for Deferring ART Among Patients Diagnosed Under the Same-Day-ART Policy in Johannesburg, South Africa

2021 ◽  
Author(s):  
Dorina Onoya ◽  
Tembeka Sineke ◽  
Idah Mokhele ◽  
Jacob Bor ◽  
Matthew P. Fox ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Self Report ◽  
Hiv Diagnosis ◽  
Adjusted Risk ◽  
Art Initiation ◽  
Art Policy ◽  
Universal Test And Treat ◽  
Post Test ◽  
Treat All

AbstractWe aimed to examine the correlates of antiretroviral therapy (ART) deferral to inform ART demand creation and retention interventions for patients diagnosed with HIV during the Universal Test and Treat (UTT) policy in South Africa. We conducted a cohort study enrolling newly diagnosed HIV-positive adults (≥ 18 years), at four primary healthcare clinics in Johannesburg between October 2017 and August 2018. Patients were interviewed immediately after HIV diagnosis, and ART initiation was determined through medical record review up to six-months post-test. ART deferral was defined as not starting ART six months after HIV diagnosis. Participants who were not on ART six-months post-test were traced and interviewed telephonically to determine reasons for ART deferral. Modified Poisson regression was used to evaluate correlates of six-months ART deferral. We adjusted for baseline demographic and clinical factors. We present crude and adjusted risk ratios (aRR) associated with ART deferral. Overall, 99/652 (15.2%) had deferred ART by six months, 20.5% men and 12.2% women. Baseline predictors of ART deferral were older age at diagnosis (adjusted risk ratio (aRR) 1.5 for 30–39.9 vs 18–29.9 years, 95% confidence intervals (CI): 1.0–2.2), disclosure of intentions to test for HIV (aRR 2.2 non-disclosure vs disclosure to a partner/spouse, 95% CI: 1.4–3.6) and HIV testing history (aRR 1.7 for  > 12 months vs < 12 months/no prior test, 95% CI: 1.0–2.8). Additionally, having a primary house in another country (aRR 2.1 vs current house, 95% CI: 1.4–3.1) and testing alone (RR 4.6 vs partner/spouse support, 95% CI: 1.2–18.3) predicted ART deferral among men. Among the 43/99 six-months interviews, women (71.4%) were more likely to self-report ART initiation than men (RR 0.4, 95% CI: 0.2–0.8) and participants who relocated within SA (RR 2.1 vs not relocated, 95% CI: 1.2–3.5) were more likely to still not be on ART. Under the treat-all ART policy, nearly 15.2% of study participants deferred ART initiation up to six months after the HIV diagnosis. Our analysis highlighted the need to pay particular attention to patients who show little social preparation for HIV testing and mobile populations.

scholarly journals Assessing rates and contextual predictors of 5-year mortality among HIV-infected and HIV-uninfected individuals following HIV testing in Durban, South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ingrid V. Bassett ◽  
Ai Xu ◽  
Janet Giddy ◽  
Laura M. Bogart ◽  
Andrew Boulle ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing

scholarly journals A matter of context – time to clinically validate 9-month infant HIV testing in South Africa(?)

2015 ◽  
Vol 105 (12) ◽  
pp. 1000
Author(s):  
Ahmad Haeri Mazanderani ◽  
Lee Fairlie ◽  
Caitlin Anna Madevu-Matson ◽  
Vivian Black ◽  
Gayle G Sherman
Keyword(s):  
South Africa ◽  
Hiv Testing
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