Uptake, Accuracy, Safety, and Linkage into Care over Two Years of Promoting Annual Self-Testing for HIV in Blantyre, Malawi: A Community-Based Prospective Study

Choko, Augustine; MacPherson, Peter; Webb, Emily L.; Willey, Barbara; Feasy, Helena; Sambakunsi, Rodrick; Mdolo, Aaron; Makombe, Simon D; Desmond, Nicola; Hayes, Richard; Maheswaran, Hendramoorthy; Corbett, Elizabeth L.

doi:10.1371/journal.pmed.1001873

Cited by 311 publications

(473 citation statements)

References 42 publications

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“…Overall, the high levels of partner testing achieved in the HIVST group are consistent with results from various studies that have shown extremely high acceptability of HIVST in SSA (Choko et al 2015;Napierala Mavedzenge et al 2013;Figueroa et al 2015;Johnson et al 2014).…”

Section: Discussionsupporting

confidence: 85%

“…This is a common limitation in many studies involving HIVST due to the private manner in which self-tests are meant to be used. Despite the potential for self-reporting to be associated with reporting bias, we believe that reporting bias was minimal given the consistency of our results for HIV testing uptake with other studies conducted in SSA (Choko et al 2011;Choko et al 2015;Thirumurthy et al 2016;Rosenberg et al 2015;Osoti et al 2014). In addition, any bias in reporting of HIV testing uptake is unlikely to be differential by study group, thereby maintaining the validity of examining the difference in HIV testing uptake between study groups.…”

Section: Discussionmentioning

confidence: 47%

“…Previous studies on HIVST in SSA have shown that it is highly acceptable and accurate (Choko et al 2011;Choko et al 2015). Innovative use of HIV self-tests provides an opportunity to address the challenges of low uptake of HIV testing among men and couples.…”

Section: Introductionmentioning

confidence: 99%

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Using HIV self-testing to promote male partner and couples testing in Kenya

Thirumurthy¹,

Omanga²,

Obonyo³

et al. 2017

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The International Initiative for Impact Evaluation (3ie) is an international grant-making non-governmental organization promoting evidence-informed development policies and programs. We are the global leader in funding, producing and synthesizing high-quality evidence of what works, for whom, why and at what cost. We believe that high-quality and policy-relevant evidence will help make development more effective and improve people's lives. 3ie impact evaluations3ie-supported impact evaluations assess the difference a development intervention has made to social and economic outcomes. 3ie is committed to funding rigorous evaluations that include a theory-based design and use the most appropriate mix of methods to capture outcomes that are useful in complex developmental contexts. About this report3ie accepted the final version of this report, Using HIV self-testing to promote male partner and couples testing in Kenya, as partial fulfillment of requirements under grant TW2.2.02 issued under the HIV self-testing thematic window. The content has been copy-edited and formatted for publication by 3ie. All the content is the sole responsibility of the authors and does not represent the opinions of 3ie, its donors or its board of commissioners. Any errors and omissions are also the sole responsibility of the authors.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 47%

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Using HIV self-testing to promote male partner and couples testing in Kenya

Thirumurthy¹,

Omanga²,

Obonyo³

et al. 2017

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“…A recent systematic review and meta-analysis that examined the effects of HIVST compared with standard HIV-testing services found that HIVST not only doubled uptake of testing among men but also improved HIV-testing frequency particularly among men who have sex with men [4]. Studies conducted in Kenya [2,3,5] and Malawi [1,6] suggest that distribution of HIVST kits to male partners through female partners is an acceptable approach that provides an opportunity for men to test for HIV without necessarily traveling to a health facility. This may overcome the barriers related to lack of time or traveling to a health facility (which men presume to be a women’s preserve) to test for HIV [7,8].…”

Section: Introductionmentioning

confidence: 99%

‘If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV’: HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda

Matovu

Kisa

Buregyeya

et al. 2018

Global Health Action

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Background: HIV self-testing (HIVST) can improve HIV-testing rates in ‘hard-to-reach’ populations, including men. We explored HIVST perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda. Methods: This was a qualitative study implemented as part of a pilot, cluster-randomized oral HIVST intervention trial among 1,514 pregnant women attending antenatal care services at three health facilities in Central Uganda. The qualitative component of the study was conducted between February and March 2017. We conducted 32 in-depth interviews to document women and men’s perceptions about HIVST, strategies used by women in delivering the kits to their male partners, male partners’ reactions to receiving kits from their female partners, and positive and negative social outcomes post-test. All interviews were audio-recorded, transcribed verbatim, and analyzed manually following a thematic framework approach. Results: Women were initially anxious about their male partners’ reaction if they brought HIVST kits home, but the majority eventually managed to deliver the kits to them successfully. Women who had some level of apprehension used a variety of strategies to deliver the kits including placing the kits in locations that would arouse male partners’ inquisitiveness or waited for ‘opportune’ moments when their husbands were likely to be more receptive. A few (three) women lied about the purpose of the test kit (testing for syphilis and other illnesses) while one woman stealthily took a mucosal swab from the husband. Most men initially doubted the ability of oral HIVST kits to test for HIV, but this did not stop them from using them. Both men and women perceived HIVST as an opportunity to learn about each other’s HIV status. No serious adverse events were reported post-test. Conclusion: Our findings lend further credence to previous findings regarding the feasibility of female-delivered HIVST to improve male partner HIV testing in sub-Saharan Africa. However, support for women in challenging relationships is required to minimize potential for deception and coercion.

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“…This was first quantified in a seminal study from Mozambique where point-of-care CD4 technologies with same-day results enabled a near doubling of patients on treatment, owing to the reduction in loss to follow-up that normally occurs when patients wait several weeks for results from centralized laboratory testing 10 . For chronic conditions such as HIV, self-testing is also being considered as a method to improve testing coverage and ultimately linkage to care 11 . Rapid results and ease of use are clearly key characteristics that are affected by the treatment paradigm or patient flow.…”

mentioning

confidence: 99%