Knowing myself first': Feasibility of self-testing among health workers in Kenya

Kalibala, Sam; Tun, Waimar; Muraah, William M; Cherutich, Peter; Oweya, Erick; Oluoch, Patricia

doi:10.31899/hiv1.1009

Cited by 29 publications

(45 citation statements)

References 1 publication

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“…Yet, the study incorporated a survey on user acceptability after performance of HST to which we refer in the discussion section. Two studies were performed in Sub-Saharan Africa [24,26], six in the USA [19,20,23,25,28,29], two in Spain [21,22], and one in Singapore [27]. Study populations consisted of risk groups like health care workers (HCW) [26], men who have sex with men (MSM), injecting drug users (IDU), clients of sexually transmitted infection (STI) clinics, women with multiple sexual partners or HIV-seropositive sexual partners [19,20,23,27-29] and the general population [21,22,24,25].…”

Section: Resultsmentioning

confidence: 99%

Acceptability of HIV self-testing: a systematic literature review

et al. 2013

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BackgroundThe uptake of HIV testing and counselling services remains low in risk groups around the world. Fear of stigmatisation, discrimination and breach of confidentiality results in low service usage among risk groups. HIV self-testing (HST) is a confidential HIV testing option that enables people to find out their status in the privacy of their homes. We evaluated the acceptability of HST and the benefits and challenges linked to the introduction of HST.MethodsA literature review was conducted on the acceptability of HST in projects in which HST was offered to study participants. Besides acceptability rates of HST, accuracy rates of self-testing, referral rates of HIV-positive individuals into medical care, disclosure rates and rates of first-time testers were assessed. In addition, the utilisation rate of a telephone hotline for counselling issues and clients` attitudes towards HST were extracted.ResultsEleven studies met the inclusion criteria (HST had been offered effectively to study participants and had been administered by participants themselves) and demonstrated universally high acceptability of HST among study populations. Studies included populations from resource poor settings (Kenya and Malawi) and from high-income countries (USA, Spain and Singapore). The majority of study participants were able to perform HST accurately with no or little support from trained staff. Participants appreciated the confidentiality and privacy but felt that the provision of adequate counselling services was inadequate.ConclusionsThe review demonstrates that HST is an acceptable testing alternative for risk groups and can be performed accurately by the majority of self-testers. Clients especially value the privacy and confidentiality of HST. Linkage to counselling as well as to treatment and care services remain major challenges.

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Section: Resultsmentioning

confidence: 99%

Acceptability of HIV self-testing: a systematic literature review

et al. 2013

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“…At the international symposium on HIVST [10], a concern was raised that frequent HIVST alone should not be used as a preventive strategy. Indeed, WHO has highlighted the importance that messaging about HIVST should clearly explain that a self-test does not provide a diagnosis and requires further testing, that HIVST should be provided with clear instructions for use and interpretation, as well as how to access HIV prevention, care and treatment services [11]. …”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Acceptability of HIV Self-Testing Among Health Care Workers in Kenya

et al. 2014

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Health care workers (HCWs) in sub-Saharan Africa are at a high risk of HIV infection from both sexual and occupational exposures. However, many do not seek HIV testing. This paper examines the acceptability of an unsupervised facility-based HIV self-testing (HIV-ST) intervention among HCWs and their partners and factors associated with uptake of HIVST among HCWs. HCWs in seven large Kenyan hospitals were invited to participate in pre-HIVST information sessions during which they were offered HIVST kits to take home for self-testing. A post-intervention survey was conducted among 765 HCWs. Forty-one percent attended the information session; of those, 89 % took the HIVST kits and of those, 85 % self-tested. Thirty-four percent of surveyed HCWs used the HIVST to test themselves. Of those who took the HIVST kit and had partners, 73 % gave the kit to their partner and 86 % of them indicated their partner self-tested. Factors positively associated with use of the HIVST on self were being female, being single, and being a HCW from Homa Bay Hospital (located in a high HIV prevalence area). HIVST is acceptable to HCWs and their partners. However, strategies are needed to increase HCWs attendance at pre-implementation information sessions.

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“…To estimate the proportion in this study at 95% confidence level with 10% margin of error, the minimum sample size of 135 pregnant women was required. An allowance was made for non-response and unusable data, as has been employed elsewhere [31], which generated an overall sample size target of at least 182 was derived, which approximates that used in other feasibility studies of oral HIV self-testing [32]. …”

Section: Methodsmentioning

confidence: 99%

Feasibility of supervised self‐testing using an oral fluid‐based HIV rapid testing method: a cross‐sectional, mixed method study among pregnant women in rural India

Sarkar

Mburu

Shivkumar

et al. 2016

Journal of the International AIDS Society

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IntroductionHIV self-testing can increase coverage of essential HIV services. This study aimed to establish the acceptability, concordance and feasibility of supervised HIV self-testing among pregnant women in rural India.MethodsA cross-sectional, mixed methods study was conducted among 202 consenting pregnant women in a rural Indian hospital between August 2014 and January 2015. Participants were provided with instructions on how to self-test using OraQuick® HIV antibody test, and subsequently asked to self-test under supervision of a community health worker. Test results were confirmed at a government-run integrated counselling and testing centre. A questionnaire was used to obtain information on patient demographics and the ease, acceptability and difficulties of self-testing. In-depth interviews were conducted with a sub-sample of 35 participants to understand their experiences.ResultsIn total, 202 participants performed the non-invasive, oral fluid-based, rapid test under supervision for HIV screening. Acceptance rate was 100%. Motivators for self-testing included: ease of testing (43.4%), quick results (27.3%) and non-invasive procedure (23.2%). Sensitivity and specificity were 100% for 201 tests, and one test was invalid. Concordance of test result interpretation between community health workers and participants was 98.5% with a Cohen's Kappa (k) value of k=0.566 with p<0.001 for inter-rater agreement. Although 92.6% participants reported that the instructions for the test were easy to understand, 18.7% required the assistance of a supervisor to self-test. Major themes that emerged from the qualitative interviews indicated the importance of the following factors in influencing acceptability of self-testing: clarity and accessibility of test instructions; time-efficiency and convenience of testing; non-invasiveness of the test; and fear of incorrect results. Overall, 96.5% of the participants recommended that the OraQuick® test kits should become publicly available.ConclusionsSelf-testing for HIV status using an oral fluid-based rapid test under the supervision of a community health worker was acceptable and feasible among pregnant women in rural India. Participants were supportive of making self-testing publicly available. Policy guidelines and implementation research are required to advance HIV self-testing for larger populations at scale.

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Knowing myself first': Feasibility of self-testing among health workers in Kenya

Cited by 29 publications

References 1 publication

Acceptability of HIV self-testing: a systematic literature review

Acceptability of HIV self-testing: a systematic literature review

Factors Associated with Acceptability of HIV Self-Testing Among Health Care Workers in Kenya

Feasibility of supervised self‐testing using an oral fluid‐based HIV rapid testing method: a cross‐sectional, mixed method study among pregnant women in rural India

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