HIV self-testing in Lusaka Province, Zambia: acceptability, comprehension of testing instructions, and individual preferences for self-test kit distribution in a population-based sample of adolescents and adults


Authors

Zanolini A, Chipungu J, Vinikoor M, Bosomprah S, Mafwenko M, Holmes C, Thirumurthy H.


Journal

AIDS Res Hum Retroviruses. 2017 Oct 2. doi: 10.1089/AID.2017.0156. [Epub ahead of print]


BACKGROUND

We assessed attitudes and preferences towards HIV self-testing (HIVST) among Zambian adolescents and adults. Methods We conducted a population-based survey of individuals aged 16-49 years old in Lusaka Province, Zambia. HIVST was shown to participants through a short video on oral fluid-based self-testing. In addition to demographics, HIV risk perceptions, and HIV testing history, we assessed participants’ acceptability and concerns regarding HIVST. Using a discrete choice experiment, we investigated preferences for the location of self-test pickup, availability of

METHODSWe conducted a population-based survey of individuals aged 16-49 years old in Lusaka Province, Zambia. HIVST was shown to participants through a short video on oral fluid-based self-testing. In addition to demographics, HIV risk perceptions, and HIV testing history, we assessed participants’ acceptability and concerns regarding HIVST. Using a discrete choice experiment, we investigated preferences for the location of self-test pickup, availability of

We conducted a population-based survey of individuals aged 16-49 years old in Lusaka Province, Zambia. HIVST was shown to participants through a short video on oral fluid-based self-testing. In addition to demographics, HIV risk perceptions, and HIV testing history, we assessed participants’ acceptability and concerns regarding HIVST. Using a discrete choice experiment, we investigated preferences for the location of self-test pickup, availability of counselling, and cost. After reviewing an instructional sheet or an additional video, we assessed participants’ understanding of self-test performance.

RESULTS

Among 1617 participants, 647 (40.0%) were men, 269 (16.6%) were adolescents and 754 (46.6%) were non-testers (i.e., no HIV test in the past 12 months). After viewing the video, 1392 (86.0%) reported that HIVST would make them more likely to test and while 35.0% reported some concerns with HIVST, only 2% were serious concerns. Participants strongly preferred HIVST over finger prick testing as well as having counselling and reported the willingness to pay out-of-pocket (US$3.5 for testers and US$5.5 for non-testers). Viewing an HIVST demonstration video did not improve participant understanding of self-test usage procedures compared to an instructional sheet alone, but it increased confidence in the ability to self-test. Conclusions HIVST was highly acceptable and desirable, especially among those not accessing existing HIV testing services. Participants expressed a strong preference for counselling and a willingness to pay for test kits. These data can guide piloting and scaling-up of HIVST in Zambia and elsewhere in Africa.

CONCLUSIONS  HIVST was highly acceptable and desirable, especially among those not accessing existing HIV testing services. Participants expressed a strong preference for counselling and a willingness to pay for test kits. These data can guide piloting and scaling-up of HIVST in Zambia and elsewhere in Africa.

HIVST was highly acceptable and desirable, especially among those not accessing existing HIV testing services. Participants expressed a strong preference for counselling and a willingness to pay for test kits. These data can guide piloting and scaling-up of HIVST in Zambia and elsewhere in Africa.

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