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


Author
Hector et al.

Publication year
2018

Country

Type of approach
Facility-based

Type of assistance
Directly assisted

Specimen
Oral-fluid

Study population
Young people: Secondary school students (16-20 years)

Study design
Feasibility/acceptability

Sample size
496

UNAIDS HIV prevalence (2017)

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.

Acceptability
0.60

Acceptability details
60% (n=299/496) accepted to self-test. 85% (n=253/299) adolescents preferred directly assisted oral HIVST to the standard HIV testing.

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
n/a

Specificity
n/a

Concordance
0.99

HIV positivity
1.7% (5/299)

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.

Source

Study status
Completed