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Feasibility of supervised self-testing using an oral fluid-based HIV rapid testing method among pregnant women in rural India


Author
Sarkar et al.

Publication year
2016

Country

Type of approach
Facility-based

Type of assistance
Directly assisted

Specimen
Oral-fluid

Study population
Pregnant women: Pregnant women

Study design
Feasibility/acceptability

Sample size
202

UNAIDS HIV prevalence (2017)
0.3

Methodology
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.

Acceptability
1

Acceptability details
Acceptance rate was 100%.

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
1

Specificity
1

Concordance
0.985

HIV positivity
0.9% (2/202)

Accuracy 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.

Social harm
n/a

Linkage to prevention, care and treatment
100% Two cases were confirmed positive, both were referred to ART centre and initiated treatment.


Study status
Completed