Usability and Acceptability of Oral Fluid Hepatitis C Self-testing Among People Who Inject Drugs in Coastal Kenya: a Cross-sectional Pilot Study

Abstract Background: People who inject drugs (PWID) are disproportionally affected by hepatitis C virus (HCV) infection and many remain undiagnosed. HCV self-testing (HCVST) may be an effective approach to increase testing uptake, but has rarely been used among PWID. We assessed the usability and acceptability of HCVST among PWID in Kenya. Methods: We conducted a cross-sectional study nested within a cohort study between August and December 2020 on Kenya’s North Coast region. Participants were handed a prototype oral fluid HCVST kit and asked to conduct the test relying on the instructions for use. Usability was assessed by documenting errors made and difficulties faced by participants. Acceptability was assessed using an interviewer-administered semi-structured questionnaire. Results: Among 150 participants, 19% were female and 65.3% had primary level education or lower. 71.3% made at least one error, 56.7% experienced some difficulty during at least one step, and the majority of participants (78%) required assistance during at least one step of the procedure. Most common errors occurred when placing the tube into the stand (18%), collecting the oral fluid sample (24%) and timing of reading results (53%). There was a strong association between presence of symptoms of opiate withdrawals and observed errors (94% vs 62%; p=0.016) in a sub-group of 74 participants assessed. Inter-reader and inter-operator concordance were 97.7% (kappa: 0.92) and 99.2% (kappa: 0.95), respectively. Acceptability assessed by asking whether participants would choose to use HCVST prior to and after conducting HCVST was 98% and 95%, respectively. Conclusions: We found a high acceptability of oral fluid HCVST among PWID. User errors were common and were associated with the presence of withdrawal symptoms among users. Despite errors, most participants were able to obtain and interpret results correctly. These findings suggest that this group of users may benefit from greater messaging and education including options to receive direct assistance when self-testing for HCV.

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Hepatitis C testing in general practice settings: A cross-sectional study of people who inject drugs in Australia

International Journal of Drug Policy ◽

10.1016/j.drugpo.2017.07.008 ◽

2017 ◽

Vol 47 ◽

pp. 102-106 ◽

Cited By ~ 10

Author(s):

Kerryn Butler ◽

Carolyn Day ◽

Rachel Sutherland ◽

Joe van Buskirk ◽

Courtney Breen ◽

...

Keyword(s):

General Practice ◽

Hepatitis C ◽

People Who Inject Drugs ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Hepatitis B virus, hepatitis C virus and human immunodeficiency virus infections among people who inject drugs in Kuwait: A cross-sectional study

Scientific Reports ◽

10.1038/s41598-019-42810-w ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Haya Altawalah ◽

Sahar Essa ◽

Sayeh Ezzikouri ◽

Widad Al-Nakib

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis C ◽

People Who Inject Drugs ◽

Cross Sectional Study ◽

Virus Hepatitis ◽

Virus Infections ◽

Sectional Study ◽

Cross Sectional ◽

B Virus ◽

Immunodeficiency Virus

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Burden of hepatitis C virus disease and access to hepatitis C virus services in people who inject drugs in India: a cross-sectional study

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(14)71045-x ◽

2015 ◽

Vol 15 (1) ◽

pp. 36-45 ◽

Cited By ~ 57

Author(s):

Sunil Suhas Solomon ◽

Shruti H Mehta ◽

Aylur K Srikrishnan ◽

Suniti Solomon ◽

Allison M McFall ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

People Who Inject Drugs ◽

Virus Disease ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Level of knowledge, acceptability, and willingness to use oral fluid HIV self-testing among medical students in Kilimanjaro region, Tanzania: a descriptive cross-sectional study

AIDS Research and Therapy ◽

10.1186/s12981-020-00311-1 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Proches Arobogast Vara ◽

Luyeye Sostenes Buhulula ◽

Fatma Aziz Mohammed ◽

Bernard Njau

Keyword(s):

Medical Students ◽

Oral Fluid ◽

Cross Sectional Study ◽

Cross Sectional ◽

Self Testing ◽

Test Kit ◽

Level Of Knowledge ◽

Self Test ◽

High Level ◽

Willingness To Use

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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Uptake of oral-based HIV self-testing among Key Populations taking HIV pre-exposure prophylaxis in central Uganda

10.21203/rs.3.rs-16837/v1 ◽

2020 ◽

Author(s):

Matovu John Bosco ◽

Jayne Byakika Tusiime ◽

Roy William Mayega ◽

Sylivia Nalubega

Keyword(s):

Sex Workers ◽

Cross Sectional Study ◽

Prior History ◽

Key Populations ◽

Time Saving ◽

Cross Sectional ◽

Self Testing ◽

Test Kit ◽

Testing Uptake ◽

Exposure Prophylaxis

Abstract Introduction: HIV incidence is higher among key populations such as sex workers, fishermen and men who have sex with men. HIV self-testing among key populations taking HIV Pre-Exposure Prophylaxis has not been studied in Uganda yet it could be an alternative testing approach for these population categories. We assessed the uptake of oral based HIV self-testing among key populations enrolled on Pre-Exposure Prophylaxis in Uganda. Methods : A mixed methods cross-sectional study was conducted on 366 key populations attending Pre-Exposure Prophylaxis clinics at MARPI Mulago and Kasensero HC II Uganda, during May-August 2018. Respondents aged 15 years and above with no prior history of HIV self-testing were issued with “Oraquick” HIV rapid diagnostic test (kit) for self-testing. Data were collected using an interviewer administered structured questionnaire and through in depth interviews of selected respondents. A chi square test was performed to determine association between socio demographic, economic factors and propensity to uptake HIV self-testing. Logistic regression was used to determine the predictors of HIV self-testing uptake. Thematic analysis was performed to explore factors that promote and inhibit HIV self-testing uptake. Results : HIV self-testing acceptability was 100% (365/365) with 73% (n=265) of respondents willing to pay for a kit. Of these, 85%(n=227) would pay not more than 1.4USD. Sixty-six percent (n=243) of respondents had high propensity to uptake HIV self-testing. Predictors of uptake were clinic location (rural vs urban) (aOR = 17.63 95% CI 8.44 – 36.81, p<0.001); Key Population category (female sex worker’s vs others) aOR= 4.36 (95% CI: 1.63 – 11.66, p=0.003) and education level ( < primary vs post primary) aOR=0.38 (95% CI: 0.20 – 0.73). Using an oral fluid based kit “Oraquick” was reported to be free of pain, convenient, easy to use and time saving. A multimodal approach to distributing HIV self-testing kits was suggested by respondents. Conclusion HIV self-testing can be an alternative to the conventional routine 3 monthly follow up HIV screening for key populations on Pre-Exposure Prophylaxis. Kits’ distribution may employ several models. Majority of key populations would afford the kits at a cost not more than 1.4USD.

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