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An assessment of oral HIV self-testing process accuracy and results interpretation among female sex worker peer educators in Kampala, Uganda


Author
Ortblad et al.

Publication year
2017

Country

Type of approach
Community-based

Type of assistance
Unassisted

Specimen
Oral-fluid

Study population
Mixed: Key population and healthcare workers: female sex worker and peer educators

Study design
Feasibility/acceptability

Sample size
104

UNAIDS HIV prevalence (2017)
6.5 [6.1-7.0]

Methodology
104 female sex workers performed an oral HIVST without supervision while observed by a trained research assistant. Participants were given no pre-test training on kit use and had only the kit's standard instructions to guide them. Study participants were asked to interpret a randomly drawn, anonymous, used oral HIV self-test kit. Self-read sensitivity and specificity were calculated in reference to the trained research assistants' interpretation of the randomly drawn tests and adjusted for the kit's sensitivity and specificity when used and interpreted as intended.

Summary of findings
61% of participants completed the necessary steps for an interpretable test result, but most (96%) struggled with the testing process in some way. Incorrect interpretation of test results was common: 23% of HIV-negative tests were interpreted as HIV-positive while 8% of HIV-positive tests were interpreted as HIV-negative. The self-interpreted real-world sensitivity and specificity were 67.9% (95% CI: 54.5-81.4%) and 67.7% (95% CI: 56.1-79.6%), respectively.

Acceptability
n/a

Acceptability details
n/a

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
0.679

Specificity
0.677

Concordance
n/a

HIV positivity
n/a

Accuracy details
Sensitivity 67.9% (95% CI: 54.5-81.4%), specificity 67.7% (95% CI: 56.1-79.6%).

Social harm
n/a

Linkage to prevention, care and treatment
n/a


Study status
Completed