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Increasing knowledge of HIV status among men: a cluster-randomised trial of community-based distribution of oral HIV self-test kits nested in four HPTN 071 communities in Zambia


Author
Ayles et al.

Publication year
2017

Country

Type of approach
Community-based

Type of assistance
Directly assisted

Specimen
Oral-fluid

Study population
General population

Study design
Trials

Sample size
26235

UNAIDS HIV prevalence (2017)
12.9 [12.3 - 13.4]

Methodology
Four of the Zambian HPTN071 intervention communities were randomised by CHiP zones, with an average of 471 households per zone. In HIVST zones (n=33/N=66), individuals aged >16 years who did not self-report being HIV-positive, were offered a choice of HIVST or HIV testing by a provider. Secondary distribution of HIVST was offered for absent partners. A population-average logistic regression model was used to estimate the effect of the HIVST intervention on knowledge of HIV status (definition: self-report HIV-positive or accepted HIV testing services), using total population enumerated as the denominator, adjusting for community, sex, and age, and accounting for clustering by zone.

Summary of findings
Between February 1st and April 30th 2017, 63.3% (8,139/12,852) of adults enumerated in the HIVST arm knew their HIV status compared to 61.3% (8203/13 383) in the non-HIVST arm, adjusted OR 1.25 (95% CI 1.01-1.56, p=0.04). Women had high knowledge of HIV status (71.1% in both HIVST and non-HIVST, adjOR 1.03, 95%CI 0.85-1.25, p=0.74). Among men, knowledge of HIV status was 55% in HIVST compared to 50.2% in non-HIVST (adjOR 1.30, 95%CI 1.07-1.60, p=0.01), with strong evidence that the effect of the HIVST intervention was different for men and women (p=0.004). Overall, introducing HIVST for 3 months in communities already exposed to door-to-door HIV-testing services for 3 years, increased the proportion of the population who knew their HIV status. This effect was seen most markedly in men.

Acceptability
n/a

Acceptability details
n/a

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
n/a

Specificity
n/a

Concordance
n/a

HIV positivity
n/a

Accuracy details
n/a

Social harm
n/a

Linkage to prevention, care and treatment
n/a


Study status
Completed

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