Feasibility of supervised self-testing using an oral fluid-based HIV rapid testing method among pregnant women in rural India
Sarkar et al.
Type of approach
Type of assistance
Pregnant women: Pregnant women
UNAIDS HIV prevalence (2017)
Between Oct - Dec 2014 a random sample of pregnant women was provided demonstration of HIV self-testing, pre-test counseling and then asked to self-test while observed by health worker. Post-test counseling and linkage to care were provided to all participants. All HIV test results were confirmed at a government integrated HIV testing services site. Participants were also asked to complete a self-administered questionaire on acceptibility and feasibility.
Summary of findings
71.5% have never been tested for HIV, 84% prefered oral HIVST to standard of care using blood-based rapid test because it was 'very easy to use' (43%), gave results 'quickly' (28%), was 'non-invasive' (22%). 92.5% participants reported instructions given were easy to understand while 7.5% found them difficult. 96% were confident they performed the self-test correctly, and 96% would recommend HIVST be made available publicly. HIV self-test results were 98% concordant with standard HIV testing services at facility. 2/202 women were identified as HIV-positive; reactive self-test results were faint lines and were confirmed positive. Two invalid test results were reported by self-testers whereas 1 invalid result was reported by a trained supervisor.
Acceptance rate was 100%.
Willingness to pay
Willingness to pay details
Sensitivity and specificity were 100% for 201 tests, and one test was invalid. Concordance of test result interpretation between community health workers and participants was 98.5% with a Cohen's Kappa (k) value of k=0.566 with p<0.001 for inter-rater agreement.
Linkage to prevention, care and treatment
100% Two cases were confirmed positive, both were referred to ART centre and initiated treatment.