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Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? a cross sectional pilot feasibility study


Author
Pant Pai et al.

Publication year
2013

Country

Type of approach
Facility-based

Type of assistance
Directly assisted

Specimen
Oral-fluid

Study population
Health-care workers

Study design
Feasibility/acceptability

Sample size
251

UNAIDS HIV prevalence (2017)
19.2 [18.4 - 20.0]

Methodology
Cross-sectional study to evaluate feasibility of HIVST with internet and paper-based self-testing programmes as well as a smartphone application. HIVST results were confirmed with rapid tests onsite and with laboratory tests.

Summary of findings
About 91% participants rated a positive experience with the strategy. Of 251 participants, 126 evaluated the internet and 125 the paper-based application successfully; completion rate of 99.2%. Nine participants were found sero-positive after confirmatory tests (prevalence 3.6% 95% CI, 1.8-6.9). Six of nine positive self-tests were accurately interpreted; sensitivity: 66.7% (95% CI, 30.9-91.0); specificity:100% (95% CI, 98.1-100).

Acceptability
n/a

Acceptability details
n/a

Willingness to pay
US$ 0.10-6.30

Willingness to pay details
57.7% (135/234) were willing to pay R1-50 (USD 0.10-6.30) and 93.2% (234/251) were willing to buy the self-test

Sensitivity
0.667

Specificity
1

Concordance
0.988

HIV positivity
3.6% (9/251)

Accuracy details
With nine sero-positives and 242 sero-negatives, the sensitivity of reading self-tests compared to lab-confirmed test results was 66.7% (95% CI, 30.9-91.0), and specificity was 100% (95% CI, 98.1-100). Positive predictive value remained at 100% (CI 95% 51.7-100) and negative predictive value was 98.8% (CI 95% 96.2-99.7).

Social harm
n/a

Linkage to prevention, care and treatment
All nine HIV-positives (100% CI 95% 66-100), received post-test counseling before treatment staging and initiation, and were offered expedited and confidential linkage to care to a clinic of their choice.

Source

Study status
Completed