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Accuracy and user-acceptability of HIV self-testing using an oral fluid-based HIV rapid test


Author
Ng et al.

Publication year
2012

Country

Type of approach
Facility-based

Type of assistance
Unassisted

Specimen
Oral-fluid

Study population
Mixed: General population and key population

Study design
Feasibility/acceptability

Sample size
994

UNAIDS HIV prevalence (2017)
0.15

Methodology
From December 2008 to August 2010, a cross-sectional study was conducted at four HIV test sites in Singapore. Study assessed accuracy and users' ability to perform and interpret self-test results using Quick ADVANCE Rapid HIV 1/2 Antibody Test (OraSure Technologies, Bethlehem, Pennsylvania, USA).

Summary of findings
Excluding invalid tests, self-testing had sensitivity of 97.4% (95% CI 95.1-99.7%) and specificity of 99.9% (95% CI: 99.6-100%). When interpreting results, 96%, 93.1% and 95.2% correctly read the positive, negative and invalid respectively. There were no significant demographic predictors for false negative self-testing or wrongly interpreting positive or invalid sample results as negative. 87% would purchase the kit over-the-counter; 89% preferred to take HIV tests in private. 72.5% and 74.9% felt the need for pre- and post-test counseling respectively. Only 28% would pay at least USD15 for the test. Self-testing was associated with high specificity, and a small but significant number of false negatives. Incorrectly identifying model results as invalid was a major reason for incorrect result interpretation. Survey responses were supportive of making self-testing available.

Acceptability
0.874

Acceptability details
87.4% of participants would purchase an HIVST

Willingness to pay
US$ 15

Willingness to pay details
Only 28% would pay at least 15USD

Sensitivity
0.974

Specificity
0.999

Concordance
n/a

HIV positivity
19.3% (192/994)

Accuracy details
Excluding invalid tests, self-testing had sensitivity of 97.4% (95% CI 95.1%-99.7%) and specificity of 99.9% (95% CI: 99.6%-100%); kappa 0.97 (0.95-0.99).

Social harm
n/a

Linkage to prevention, care and treatment
n/a

Source

Study status
Completed