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Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM

BACKGROUND: HIV self-testing (HIVST) may increase HIV testing uptake, facilitating earlier treatment for key populations like MSM who experience barriers accessing clinic-based HIV testing. HIVST usability among African MSM has not been explored. METHODS: We assessed usability of oral fluid (OF) and...

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Autores principales: Lippman, Sheri A., Gilmore, Hailey J., Lane, Tim, Radebe, Oscar, Chen, Yea-Hung, Mlotshwa, Nkuli, Maleke, Kabelo, Manyuchi, Albert E., McIntyre, James
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224086/
https://www.ncbi.nlm.nih.gov/pubmed/30408055
http://dx.doi.org/10.1371/journal.pone.0206849
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author Lippman, Sheri A.
Gilmore, Hailey J.
Lane, Tim
Radebe, Oscar
Chen, Yea-Hung
Mlotshwa, Nkuli
Maleke, Kabelo
Manyuchi, Albert E.
McIntyre, James
author_facet Lippman, Sheri A.
Gilmore, Hailey J.
Lane, Tim
Radebe, Oscar
Chen, Yea-Hung
Mlotshwa, Nkuli
Maleke, Kabelo
Manyuchi, Albert E.
McIntyre, James
author_sort Lippman, Sheri A.
collection PubMed
description BACKGROUND: HIV self-testing (HIVST) may increase HIV testing uptake, facilitating earlier treatment for key populations like MSM who experience barriers accessing clinic-based HIV testing. HIVST usability among African MSM has not been explored. METHODS: We assessed usability of oral fluid (OF) and fingerstick (FS; blood) HIVST kits during three phases among MSM with differing degrees of HIVST familiarity in Mpumalanga, South Africa. In 2015, 24 HIVST-naïve MSM conducted counselor-observed OF and FS HIVST after brief demonstration. In 2016 and 2017, 45 and 64 MSM with experience using HIVST in a pilot study chose one HIVST to conduct with a counselor-observer present. In addition to written, the latter group had access to video instructions. We assessed frequency of user errors and reported test use ease, changes in error frequency by phase, and covariates associated with correct usage using log-Poisson and Gaussian generalized estimating equations. RESULTS: Among OF users (n = 57), 15–30% committed errors in each phase; however, observers consistently rated participants as able to test alone. Among FS users (n = 100), observers noted frequent errors, most commonly related to blood collection and delivery. We found suggestive evidence (not reaching statistical significance) that user errors decreased, with 37.5%, to 28.1%, and 18.2% committing errors in phases I, II, and III, respectively (p-value:0.08), however observer concerns remained constant. Ease and confidence using HIVST increased with HIV testing experience. Participants using three HIVST were more likely (RR:1.92, 95% CI:1.32, 2.80) to report ease compared to those without prior HIVST experience. Never testers (RR:0.66, 95% CI:0.44–0.99) reported less ease performing HIVST compared to participants testing in the past six months. CONCLUSIONS: MSM were able to perform the OF test. Fingerstick test performance was less consistent; however preference for fingerstick was strong and performance may improve with exposure and instructional resources. Continued efforts to provide accessible instructions are paramount.
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spelling pubmed-62240862018-11-19 Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM Lippman, Sheri A. Gilmore, Hailey J. Lane, Tim Radebe, Oscar Chen, Yea-Hung Mlotshwa, Nkuli Maleke, Kabelo Manyuchi, Albert E. McIntyre, James PLoS One Research Article BACKGROUND: HIV self-testing (HIVST) may increase HIV testing uptake, facilitating earlier treatment for key populations like MSM who experience barriers accessing clinic-based HIV testing. HIVST usability among African MSM has not been explored. METHODS: We assessed usability of oral fluid (OF) and fingerstick (FS; blood) HIVST kits during three phases among MSM with differing degrees of HIVST familiarity in Mpumalanga, South Africa. In 2015, 24 HIVST-naïve MSM conducted counselor-observed OF and FS HIVST after brief demonstration. In 2016 and 2017, 45 and 64 MSM with experience using HIVST in a pilot study chose one HIVST to conduct with a counselor-observer present. In addition to written, the latter group had access to video instructions. We assessed frequency of user errors and reported test use ease, changes in error frequency by phase, and covariates associated with correct usage using log-Poisson and Gaussian generalized estimating equations. RESULTS: Among OF users (n = 57), 15–30% committed errors in each phase; however, observers consistently rated participants as able to test alone. Among FS users (n = 100), observers noted frequent errors, most commonly related to blood collection and delivery. We found suggestive evidence (not reaching statistical significance) that user errors decreased, with 37.5%, to 28.1%, and 18.2% committing errors in phases I, II, and III, respectively (p-value:0.08), however observer concerns remained constant. Ease and confidence using HIVST increased with HIV testing experience. Participants using three HIVST were more likely (RR:1.92, 95% CI:1.32, 2.80) to report ease compared to those without prior HIVST experience. Never testers (RR:0.66, 95% CI:0.44–0.99) reported less ease performing HIVST compared to participants testing in the past six months. CONCLUSIONS: MSM were able to perform the OF test. Fingerstick test performance was less consistent; however preference for fingerstick was strong and performance may improve with exposure and instructional resources. Continued efforts to provide accessible instructions are paramount. Public Library of Science 2018-11-08 /pmc/articles/PMC6224086/ /pubmed/30408055 http://dx.doi.org/10.1371/journal.pone.0206849 Text en © 2018 Lippman et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lippman, Sheri A.
Gilmore, Hailey J.
Lane, Tim
Radebe, Oscar
Chen, Yea-Hung
Mlotshwa, Nkuli
Maleke, Kabelo
Manyuchi, Albert E.
McIntyre, James
Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM
title Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM
title_full Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM
title_fullStr Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM
title_full_unstemmed Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM
title_short Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM
title_sort ability to use oral fluid and fingerstick hiv self-testing (hivst) among south african msm
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224086/
https://www.ncbi.nlm.nih.gov/pubmed/30408055
http://dx.doi.org/10.1371/journal.pone.0206849
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