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Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?

BACKGROUND: Although HIV self-tests are recommended by the WHO, they are not yet approved in Canada. Service delivery gaps such as linkages to counseling and care remain unachieved by offering self-tests without adequate support. In this first Canadian study, we evaluated the feasibility of operatio...

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Autores principales: Pai, Nitika Pant, Smallwood, Megan, Desjardins, Laurence, Goyette, Alexandre, Vassal, Anne-Fanny, Thomas, Réjean
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631212/
http://dx.doi.org/10.1093/ofid/ofx163.1075
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author Pai, Nitika Pant
Smallwood, Megan
Desjardins, Laurence
Goyette, Alexandre
Vassal, Anne-Fanny
Thomas, Réjean
author_facet Pai, Nitika Pant
Smallwood, Megan
Desjardins, Laurence
Goyette, Alexandre
Vassal, Anne-Fanny
Thomas, Réjean
author_sort Pai, Nitika Pant
collection PubMed
description BACKGROUND: Although HIV self-tests are recommended by the WHO, they are not yet approved in Canada. Service delivery gaps such as linkages to counseling and care remain unachieved by offering self-tests without adequate support. In this first Canadian study, we evaluated the feasibility of operationalizing an innovative HIVSmart! app-optimized oral HIV self-testing strategy in men who have sex with men (MSM), presenting at a large sexual health clinic in Montreal. METHODS: Between July 2016 to February 2017, participants were offered the OraQuick In-Home HIV Test, and a tablet installed with the HIVSmart! app, at a private office in the clinic to simulate an unsupervised home environment. With the HIVSmart! app, participants independently performed and interpreted self-tests, and were linked to in-person post-test counseling and care. Self-test results were confirmed by laboratory tests (p24, Western Blot, RNA as needed). RESULTS: The mean age of the 451 participants was 34 years (18–73); 85% were well educated (beyond high school, n = 371/438); 53% (230/438) were frequent testers (past 6 months), and 13% were on PrEP (52/451). 99% (417/422) of participants found the HIVSmart! app helpful in guiding them through the self-testing procedure; 93% (418/451) of participants interpreted their tests accurately; and 94% (395/419) stated they would recommend the app-optimized self-testing strategy to their partners. Feasibility (completion rate of self-testing) was 93% (419/451), and acceptability of the strategy was high at 99% (451/458). All HIV self-test negative participants (448/451, 100%) were counseled following the self-test. Three participants self-tested positive, were confirmed HIV positive (0.7% prevalence), and were rapidly linked to care with a physician. CONCLUSION: The HIVSmart! app-optimized strategy was feasible, and highly accepted by an educated, frequently testing, urban MSM population of Montréal. With the app, participants were able to interpret their test results accurately and were rapidly linked to care. Innovations like HIVSmart! which engage, aid, and facilitate linkages to care, can be adapted to suit the needs of many populations in Canada and internationally, maximizing global impact through reverse innovation. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-56312122017-11-07 Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada? Pai, Nitika Pant Smallwood, Megan Desjardins, Laurence Goyette, Alexandre Vassal, Anne-Fanny Thomas, Réjean Open Forum Infect Dis Abstracts BACKGROUND: Although HIV self-tests are recommended by the WHO, they are not yet approved in Canada. Service delivery gaps such as linkages to counseling and care remain unachieved by offering self-tests without adequate support. In this first Canadian study, we evaluated the feasibility of operationalizing an innovative HIVSmart! app-optimized oral HIV self-testing strategy in men who have sex with men (MSM), presenting at a large sexual health clinic in Montreal. METHODS: Between July 2016 to February 2017, participants were offered the OraQuick In-Home HIV Test, and a tablet installed with the HIVSmart! app, at a private office in the clinic to simulate an unsupervised home environment. With the HIVSmart! app, participants independently performed and interpreted self-tests, and were linked to in-person post-test counseling and care. Self-test results were confirmed by laboratory tests (p24, Western Blot, RNA as needed). RESULTS: The mean age of the 451 participants was 34 years (18–73); 85% were well educated (beyond high school, n = 371/438); 53% (230/438) were frequent testers (past 6 months), and 13% were on PrEP (52/451). 99% (417/422) of participants found the HIVSmart! app helpful in guiding them through the self-testing procedure; 93% (418/451) of participants interpreted their tests accurately; and 94% (395/419) stated they would recommend the app-optimized self-testing strategy to their partners. Feasibility (completion rate of self-testing) was 93% (419/451), and acceptability of the strategy was high at 99% (451/458). All HIV self-test negative participants (448/451, 100%) were counseled following the self-test. Three participants self-tested positive, were confirmed HIV positive (0.7% prevalence), and were rapidly linked to care with a physician. CONCLUSION: The HIVSmart! app-optimized strategy was feasible, and highly accepted by an educated, frequently testing, urban MSM population of Montréal. With the app, participants were able to interpret their test results accurately and were rapidly linked to care. Innovations like HIVSmart! which engage, aid, and facilitate linkages to care, can be adapted to suit the needs of many populations in Canada and internationally, maximizing global impact through reverse innovation. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5631212/ http://dx.doi.org/10.1093/ofid/ofx163.1075 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Pai, Nitika Pant
Smallwood, Megan
Desjardins, Laurence
Goyette, Alexandre
Vassal, Anne-Fanny
Thomas, Réjean
Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?
title Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?
title_full Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?
title_fullStr Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?
title_full_unstemmed Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?
title_short Can an HIVSmart! App-optimized Self-Testing Strategy be Operationalized in Canada?
title_sort can an hivsmart! app-optimized self-testing strategy be operationalized in canada?
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631212/
http://dx.doi.org/10.1093/ofid/ofx163.1075
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