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.