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Will an unsupervised self-testing strategy be feasible to operationalize in Canada? Results from a pilot study in students of a large Canadian university


Author
Pant Pai et al.

Publication year
2014

Country

Type of approach
Facility-based

Type of assistance
Directly assisted

Specimen
Oral-fluid

Study population
Young people: Young people: university students (median age 22 years)

Study design
Feasibility/acceptability

Sample size
145

UNAIDS HIV prevalence (2017)
0.01

Methodology
Cross-sectional study. After initial blood test performed by clinic staff confirmed seronegativity, study participants were presented a pre-test questionnaire and oral fluid-based self-testing kit with instructions and timer. Participants then completed a self-test without supervision. Next, the health-care worker performed the test with the participant. Finally, participants completed a post-test questionnaire.

Summary of findings
Results from the self-tests performed by students had 100% agreement with the test performed at the point-of-care by the health-care provider. No false negative or indeterminate results were recorded with either test. Regarding acceptability of self-testing, 81% (n=117) of students preferred the oral self-test to the laboratory test, and 87% (n=126) were confident about interpreting their test results themselves. Almost all (99%, n=143) found the test to be convenient. For post-test counseling and linkages, community clinics (78%) were the top choice, followed by phone (54%), pharmacies (33%), and the internet (30%). Approximately 41% were comfortable with either anonymous or face-to-face counseling, whereas 39% preferred face-to-face and 16% preferred anonymous counseling. Approximately 74% expressed willingness to buy self-tests over-the-counter, but only 28% were willing to pay more thanUS$20.

Acceptability
0.81

Acceptability details
Regarding acceptability of self-testing, 81% (n=117) of students preferred the oral self-test to the laboratory test.

Willingness to pay
US$ 20

Willingness to pay details
Approximately 74% expressed willingness to buy self-tests over-the-counter, but only 28% were willing to pay more than US$20.

Sensitivity
n/a

Specificity
n/a

Concordance
1

HIV positivity
0% (0/145)

Accuracy details
Results from the self-tests performed by students had 100% agreement with the test performed at the point-of-care by the health-care worker. No false negative or indeterminate results were recorded with either test.

Social harm
n/a

Linkage to prevention, care and treatment
n/a


Study status
Completed