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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: A cross-sectional feasibility study in Blantyre, Malawi
PLoS Medicine, Volume 8, No. 10, Article e1001102, Year 2011
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Description
Background: Although HIV testing and counseling (HTC) uptake has increased dramatically in Africa, facility-based services are unlikely to ever meet ongoing need to the full. A major constraint in scaling up community and home-based HTC services is the unacceptability of receiving HTC from a provider known personally to prospective clients. We investigated the potential of supervised oral HIV self-testing from this perspective. Methods and Findings: Adult members of 60 households and 72 members of community peer groups in urban Blantyre, Malawi, were selected using population-weighted random cluster sampling. Participants were offered self-testing plus confirmatory HTC (parallel testing with two rapid finger-prick blood tests), standard HTC alone, or no testing. 283 (95.6%) of 298 selected adults participated, including 136 (48.0%) men. 175 (61.8%) had previously tested (19 known HIV positive), although only 64 (21.5%) within the last year. HIV prevalence was 18.5%. Among 260 (91.9%) who opted to self-test after brief demonstration and illustrated instructions, accuracy was 99.2% (two false negatives). Although 98.5% rated the test "not hard at all to do," 10.0% made minor procedural errors, and 10.0% required extra help. Most participants indicated willingness to accept self-test kits, but not HTC, from a neighbor (acceptability 94.5% versus 46.8%, p = 0.001). Conclusions: Oral supervised self-testing was highly acceptable and accurate, although minor errors and need for supervisory support were common. This novel option has potential for high uptake at local community level if it can be supervised and safely linked to counseling and care. Please see later in the article for the Editors' Summary. © 2011 Choko et al.
Authors & Co-Authors
Choko, Augustine Talumba
Unknown Affiliation
Desmond, Nicola Ann
Unknown Affiliation
Webb, Emily L.
Unknown Affiliation
Chavula, Kondwani
Unknown Affiliation
Napierala-Mavedzenge, Sue Naperiela
Unknown Affiliation
Gaydos, Charlotte Ann
Unknown Affiliation
Makombe, Simon D.
Unknown Affiliation
Chunda, Treza
Unknown Affiliation
Squire, S. Bertel
Unknown Affiliation
French, N.
Unknown Affiliation
Mwapasa, Victor
Unknown Affiliation
Corbett, Elizabeth L.
Unknown Affiliation
Statistics
Citations: 296
Authors: 12
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pmed.1001102
ISSN:
15491277
e-ISSN:
15491676
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Malawi
Participants Gender
Male