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Are participants in a street-based HIV testing program able to perform their own rapid test and interpret the results?


Author
de la Fuente et al.

Publication year
2012

Country

Type of approach
Community-based

Type of assistance
Both

Specimen
Fingerstick/whole blood

Study population
Key population: Men who have sex with men

Study design
Feasibility/acceptability

Sample size
519

UNAIDS HIV prevalence (2017)
0.4 [0.3 - 0.4]

Methodology
Cross-sectional study nested in a public health program run by 'Madrid Positivo' between October 2009 and February 2010. Before being tested, one group of participants were given only adapted instructions and a test kit (unassisted), and performed the self-test non-observed (finger stick tests (Determine HIV Combo), to detect both antigen and antibody, that use whole blood were used, but did not use capillary tube to ease use). The other group of participants performed observed self-testing and received additional instructions on how to interpret the test results shown in 6 photos and filled out a questionnaire (directly-assisted).

Summary of findings
About 8.0% (95%CI:4.8%-11.2%) obtained an invalid self-test. An invalid result was inversely associated with male participants who had sex with men (OR = 0.3;95%CI:0.1-1.0). Of the 3111 photos interpreted, 4.9% (95%CI:4.1-5.7) were incorrect. Only 1.1% (95%CI:0.3-1.8) of the positive results were interpreted as negative. Age 30 or older (OR = 2.1; 95%CI:1.2-3.7), having been born in Latin America (OR = 1.6; 95%CI:1.1-2.2), and not having university education (OR = 2.1;95%CI:1.2-3.7) were associated with misinterpreting test results. Participants' perceptions of both their proficiency when conducting the test and interpretation were related with actual outcomes. Most participants (83.9%) were more motivated than before to use the self-test in the future, and 51.7% would pay >10 euros for the test if it was sold in pharmacies.

Acceptability
0.839

Acceptability details
After participating in the study most participants (83.9%) were more motivated than before to use the self-test in the future.

Willingness to pay
n/a

Willingness to pay details
51.7% (n=n/a) would pay >10 euros for the test if it was sold in pharmacies.

Sensitivity
n/a

Specificity
n/a

Concordance
0.854

HIV positivity
n/a

Accuracy details
85.4% (445/521) concordance

Social harm
n/a

Linkage to prevention, care and treatment
n/a

Source

Study status
Completed