Acceptability and performance of a directly assisted oral HIV self-testing intervention in adolescents in rural Mozambique

Methodology

Adolescents students aged 16–20 years were invited to attend the local hospital’s youth friendly service to receive directly assisted oral HIVST. Participants completed a baseline questionnaire regarding sociodemographic characteristics, HIV risk perception, prior HIV testing, knowledge of health services, and the use of family planning; and post-test questionnaires to capture acceptability of HIVST and difficulties performing HIVST. All participants received a detailed individual demonstration of HIVST, 60% (n=299/496) accepted to self-test, results were read by the participant and by a nurse. Participants received confirmatory testing in line with Mozambican testing standards. Inter-rater agreement was evaluated by calculation of kappa. This study also evaluated factors associated with attendance for directly assisted HIVST post invitation. Study period: September and November 2016.

Summary of findings

496 adolescents were included, of which 299 performed an oral HIV self-test. 70% (n=/496) were first time testers. The positivity rate was 1.7% (n=5/299). The inter-rater agreement between adolescent and nurse was 99.6% (kappa 0.93); there were no false negative or false positive results of the oral HIV self-test. Five tests were invalid. 7.1% (n=21/299) of participants found the test difficult to use. Over 80% (n=253/299) preferred directly assisted HIVST compared to the standard finger prick testing.

Accuracy details

99.6% concordance (kappa 0.93)

Social harm

n/a

Linkage to prevention, care and treatment

100% all participants received further testing as part of the study procedure. There's no information about linkage to treatment and care.