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Supervised, blood-based self-sample collection and rapid test performance: a valuable alternative to the use of saliva by HIV testing programmes with no medical or nursing staff


Author
Belza et al.

Publication year
2012

Country

Type of approach
Community-based

Type of assistance
Directly assisted

Specimen
Fingerstick/whole blood

Study population
Mixed: Key population, young people and healthcare workers: clients of non-govermental organisation requesting a rapid HIV test, including women, men who have sex with men, and men who have sex with women. 42.9% of participants were under age 25.

Study design
Feasibility/acceptability

Sample size
208

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

Methodology
209 Spanish-speaking attendees at a street-based HIV testing programme in Madrid participated in the study (study survey). Participants were tested twice, first in the study and then in the programme, using the same finger-stick whole-blood rapid test.

Summary of findings
Of 267 participants offered the opportunity to self-test, 208 (78%) accepted. Those accepting were primarily recruited from a gay neighbourhood (64%), were under 25 years of age (43%), were immigrants (16%), had a university education (58%), and were single (91%). 29% lived outside of the city and 2% reported that they earned money from illegal activities. 38% identified as men who have sex with men, 22% identified as heterosexual men and 41% identified as heterosexual women. More than half (57%) had never tested for HIV before. 99% (95% CI 96.6%-99.9%) of participants (206/208) had a valid self-test result and this was equivalent to HIV testing provided by a doctor/nurse in the programme test. In the 2 cases where test results were invalid, counsellors indicated the blood sample was correctly obtained and sufficient blood was utilized. Four participants (1.9%) (95% CI 0.5%-4.9%) had a reactive self-test, all were confirmed HIV-positive. None were reactive to p24 antigen.

Acceptability
0.779

Acceptability details
77.9% of participants who were offered the opportunity to self-test accepted.

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
n/a

Specificity
n/a

Concordance
0.99

HIV positivity
n/a

Accuracy details
99% (95% CI 96.6-99.9%) of participants had a valid result on the study test. This was the same percentage for the accuracy of the programme test administered by a doctor or nurse.

Social harm
n/a

Linkage to prevention, care and treatment
Participants then performed the test under the guidance of the counsellor. Demographic and risk behaviour data were collected by a self-administered questionnaire. The test results in the programme and the study were read by the study counsellor.


Study status
Completed