User acceptability and feasibility of self-testing with HIV rapid tests
Lee et al.
Type of approach
Type of assistance
Mixed: General population and key population: people living with HIV, at risk individuals with unknown HIV status, men who have sex with men, heterosexual
UNAIDS HIV prevalence (2017)
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.
Willingness to pay
Willingness to pay details
Most participants were willing to pay between 7$ and 13$ USD.
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.
Linkage to prevention, care and treatment
All participants received confirmatory testing.