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User acceptability and feasibility of self-testing with HIV rapid tests


Author
Lee et al.

Publication year
2007

Country

Type of approach
Facility-based

Type of assistance
Unassisted

Specimen
Fingerstick/whole blood

Study population
Mixed: General population and key population: people living with HIV, at risk individuals with unknown HIV status, men who have sex with men, heterosexual

Study design
Feasibility/acceptability

Sample size
350

UNAIDS HIV prevalence (2017)
0.15

Methodology
Cross-sectional study. Participants utilised blood-based Abbott Determine HIV 1/2 rapid test at an HIV test center. Trained professionals then performed the same test. Participants were surveyed before and after performing the self-test. Ability to identify test outcomes was determined through interpretation of sample test results.

Summary of findings
Eighty-nine percent of participants preferred testing in private, but most indicated that confidential counseling by trained counselors was necessary. Almost 90% found the kit easy to use and instructions easy to understand. Nevertheless, 85% failed to perform all steps correctly, especially blood sampling, and 56% had invalid results because of incorrect test performance. Inter-rater agreement between results from self-testing and trained personnel testing had a kappa value of 0.28. Twelve percent could not correctly determine results using sample tests, including 2% and 7% who read positive and negative samples, respectively, incorrectly. A substantial proportion could not perform self-testing or identify outcomes. Research concluded that self-testing with the Determine HIV 1/2 kit in Singapore should be deferred.

Acceptability
n/a

Acceptability details
n/a

Willingness to pay
US$ 7-13

Willingness to pay details
Most participants were willing to pay between 7$ and 13$ USD.

Sensitivity
0.989

Specificity
0.996

Concordance
n/a

HIV positivity
24.3% (84/345)

Accuracy details
Sensitivity was 98.9% and specificity was was 99.6% when the test was performed by trained personnel. Nevertheless, 85% of participants failed to perform all steps correctly, especially blood sampling, and 56% had invalid results because of incorrect test performance. As a substantial proportion could not perform self-testing or identify outcomes, researchers concluded that self-testing with the Determine HIV 1/2 kit in Singapore should be deferred.

Social harm
n/a

Linkage to prevention, care and treatment
All participants received confirmatory testing.


Study status
Completed