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Tran A, Tran N, Tapa J, Tieosapjaroen W, Fairley CK, Chow EPF, Zhang L, Baggaley RC, Johnson CC, Jamil MS, Ong JJ. A typology of HIV self-testing support systems: a scoping review. Sex Health 2024; 21:SH24037. [PMID: 38950142 DOI: 10.1071/sh24037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/04/2024] [Indexed: 07/03/2024]
Abstract
To maximise the benefits of HIV self-testing (HIVST), it is critical to support self-testers in the testing process and ensure that they access appropriate prevention and care. To summarise systems and tools supporting HIVST (hereafter, 'support systems') and categorise them for future analysis, we synthesised the global data on HIVST support systems and proposed a typology. We searched five databases for articles reporting on one or more HIVST support systems and included 314 publications from 224 studies. Across 189 studies, there were 539 reports of systems supporting HIVST use; while across 115 studies, there were 171 reports of systems supporting result interpretation. Most commonly, these were pictorial instructions, followed by in-person demonstrations and in-person assistance while self-testing or reading self-test results. Less commonly, virtual interventions were also identified, including online video conferencing and smartphone apps. Smartphone-based automated result readers have been used in the USA, China, and South Africa. Across 173 studies, there were 987 reports of systems supporting post-test linkage to care; most commonly, these were in-person referrals/counselling, written referrals, and phone helplines. In the USA, Bluetooth beacons have been trialled to monitor self-test use and facilitate follow-up. We found that, globally, HIVST support systems use a range of methods, including static media, virtual tools, and in-person engagement. In-person and printed approaches were more common than virtual tools. Other considerations, such as linguistic and cultural appropriateness, may also be important in the development of effective HIVST programs.
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Affiliation(s)
- Arron Tran
- Melbourne Medical School, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic, Australia; and Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia
| | - Nghiep Tran
- Melbourne Medical School, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic, Australia
| | - James Tapa
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia
| | - Warittha Tieosapjaroen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia
| | - Lei Zhang
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Rachel C Baggaley
- Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Cheryl C Johnson
- Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Muhammad S Jamil
- Department of Communicable Diseases, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Jason J Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia; and Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia; and Department of Communicable Diseases, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
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Mhando F, Olughu K, Nyankomo M, Ngocho JS, Teri I, Mbita G, Conserve DF. Men's Willingness to Receive Text Messages and Talk with an HIV counselor from the National HIV Hotline in Tanzania for Support with Linkage to Care Following HIV self-testing. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.01.24308312. [PMID: 38883795 PMCID: PMC11177922 DOI: 10.1101/2024.06.01.24308312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background Tanzania faces a significant burden of HIV, with particular challenges in reaching men and ensuring timely linkage to care. To address these issues, HIV self-testing (HIVST) has been implemented to increase HIV testing and the National HIV Hotlines are being considered as a strategy to facilitate linkage to care. This study aimed to assess the willingness of Tanzanian men to receive support from use the National HIV Hotline via mobile phones for HIVST and linkage to care. Methods Data from 505 men from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or "camps" in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. Logistic regression models were used to assess factors associated with men's comfort with talking with an HIV counselor over the phone. Results There were 505 heterosexual male participants enrolled in the study with an average age of 29 years. Logistic regression demonstrated that comfortability texting a friend about HIV self-testing (OR =3.37, 95% CI [1.97 - 5.76], being comfortable texting a friend about HIV (OR = 3.84, 95% CI [2.20 - 6.72], previous history of receiving HIV related text messages (aOR = 0.55, 95% CI [0.31 - 0.99] were significantly associated with men's s comfortability talking to a HIV counselor on the National HIV Hotline following HIVST. The factors such as participants' comfortability texting friend about HIVST (OR = 2.52, 95% CI [1.49 - 4.25]) and comfortability texting friend about HIV (OR = 2.96, 95% CI [1.83 - 4.80] were significantly associated with the probability of participant's comfortability receiving text message from HIV counselor following HIVST. Conclusion These findings suggest an effort to develop and implement a user-friendly digital health intervention that promote comfortability, address private concerns, and deliver tailored support and information to individuals following HIV self-testing.
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Affiliation(s)
- Frank Mhando
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
| | - Kelia Olughu
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Marwa Nyankomo
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
| | - James S. Ngocho
- Department of Epidemiology and Applied Biostatistics, Kilimanjaro Christian Medical University College, Moshi Tanzania
| | - Ivan Teri
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA
| | | | - BRIDGE Africa Team
- Building Research Implementation to Drive Growth and Equity (BRIDGE) Africa, Dar es Salaam, Tanzania
| | - Donaldson F. Conserve
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Katzenschlager S, Brümmer LE, Schmitz S, Tolle H, Manten K, Gaeddert M, Erdmann C, Lindner A, Tobian F, Grilli M, Pollock NR, Macé A, Erkosar B, Carmona S, Ongarello S, Johnson CC, Sacks JA, Denkinger CM, Yerlikaya S. Comparing SARS-CoV-2 antigen-detection rapid diagnostic tests for COVID-19 self-testing/self-sampling with molecular and professional-use tests: a systematic review and meta-analysis. Sci Rep 2023; 13:21913. [PMID: 38081881 PMCID: PMC10713601 DOI: 10.1038/s41598-023-48892-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
Self-testing is an effective tool to bridge the testing gap for several infectious diseases; however, its performance in detecting SARS-CoV-2 using antigen-detection rapid diagnostic tests (Ag-RDTs) has not been systematically reviewed. This study aimed to inform WHO guidelines by evaluating the accuracy of COVID-19 self-testing and self-sampling coupled with professional Ag-RDT conduct and interpretation. Articles on this topic were searched until November 7th, 2022. Concordance between self-testing/self-sampling and fully professional-use Ag-RDTs was assessed using Cohen's kappa. Bivariate meta-analysis yielded pooled performance estimates. Quality and certainty of evidence were evaluated using QUADAS-2 and GRADE tools. Among 43 studies included, twelve reported on self-testing, and 31 assessed self-sampling only. Around 49.6% showed low risk of bias. Overall concordance with professional-use Ag-RDTs was high (kappa 0.91 [95% confidence interval (CI) 0.88-0.94]). Comparing self-testing/self-sampling to molecular testing, the pooled sensitivity and specificity were 70.5% (95% CI 64.3-76.0) and 99.4% (95% CI 99.1-99.6), respectively. Higher sensitivity (i.e., 93.6% [95% CI 90.4-96.8] for Ct < 25) was estimated in subgroups with higher viral loads using Ct values as a proxy. Despite high heterogeneity among studies, COVID-19 self-testing/self-sampling exhibits high concordance with professional-use Ag-RDTs. This suggests that self-testing/self-sampling can be offered as part of COVID-19 testing strategies.Trial registration: PROSPERO: CRD42021250706.
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Affiliation(s)
- Stephan Katzenschlager
- Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Lukas E Brümmer
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
- German Center for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Heidelberg, Germany
| | - Stephani Schmitz
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
- Department of Developmental Biology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Hannah Tolle
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Katharina Manten
- Department of Anesthesiology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | - Mary Gaeddert
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | | | - Andreas Lindner
- Charité Center for Global Health, Institute of International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Frank Tobian
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
| | | | - Nira R Pollock
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA
| | | | | | | | | | - Cheryl C Johnson
- Global HIV, Hepatitis and STIs Programmes, World Health Organization, Geneva, Switzerland
| | - Jilian A Sacks
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Claudia M Denkinger
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany
- German Center for Infection Research (DZIF), Partner Site Heidelberg University Hospital, Heidelberg, Germany
| | - Seda Yerlikaya
- Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120, Heidelberg, Germany.
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Evaluation of factors associated with HIV self-testing Acceptability and Uptake among the MSM community in Nairobi, Kenya: A cross sectional study. PLoS One 2023; 18:e0280540. [PMID: 36893161 PMCID: PMC9997958 DOI: 10.1371/journal.pone.0280540] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 01/03/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Human Immunodeficiency Virus self-test (HIVST) refers to a process where a person collects his or her own specimen (blood or oral), performs a test and interprets the results. The interpretation of results can either be done in private or through support of a trusted partner. Self-test should be seen as screening and confirmatory tests are typically strongly encouraged. STUDY OBJECTIVE To determine facilitating factors for HIVST acceptability and uptake among men who have sex with men (MSM). METHODS A cross-sectional exploratory study design, targeting MSM in Nairobi was used. Adult men (aged 18-60 years) who reported to be actively engaging in anal or oral sex with men were eligible for the study. Purposive sampling was used to identify the sites where data was collected, snowballing technique was then employed to reach the respondents. Data was collected between July 2018 and June 2019. A total of 391 MSM respondent were recruited of whom 345 MSM completed the questionnaires. The missing data was handled through the listwise approach that omits those cases with the missing data and analyze the remaining data. We also excluded responses with inconsistencies in all confirmatory questions in the questionnaire. RESULTS Two-thirds (64.0%) of the participants were aged 18-24 years with 13.4% being married to women and 40.2% having tertiary level of education. Majority, 72.7% were unemployed and two-thirds (64.0%) of participants were young (18-24 years) and self reported as male sex workers (58.8). There were significant associations between willingness to undertake HIV self-tests and frequency of HIV testing as well as with previous knowledge about self-testing. Habitual HIV testers were more likely to have used the HIVST kit than the non-habitual testers. Willingness to undertake confirmatory test within one month of self-testing was associated with acceptability of HIVST. Most of the MSM preferred blood sample self-test kits as compared to oral self-test kits, believing that blood test will be more accurate than oral self-test. Other factors associated with HIVST included consistent use of protection regardless of HIV status, preference of "treatment buddies". High costs of the self-test kits and inadequate knowledge on the use of HIV self-test kits were the main hindrances to HIVST uptake. CONCLUSIONS This study has showed that age, habitual testing, self-care/partner care, as well as confirmatory testing and immediate introduction into care if found sero-positive were associated with the use of HIVST kit. This study contributes to the pool of knowledge of the characteristics of MSM that would adopt and embrace HIVST, and demonstrates that these MSM are self and partner care aware and conscious. The challenge however remains on how to encourage those that are not self/partner care aware to embrace HIV testing and particularly HIVST as routine practices. Future studies may need to explore potential motivators to self-testing among the young, elder MSM generations and the MSM with higher economic status in Kenya.
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Hong C, Yu F, Xue H, Zhang D, Mi G. HIV Testing Among Gay, Bisexual, and Other Men Who Have Sex with Men During the COVID-19 Pandemic in China: Implications for Promoting HIV Self-Testing Among Key Populations. AIDS Patient Care STDS 2022; 36:451-457. [PMID: 36394476 DOI: 10.1089/apc.2022.0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 pandemic has created additional barriers to accessing sexual health services among gay, bisexual, and other men who have sex with men (GBMSM) in China. Yet, little is known about the frequency of HIV testing and how GBMSM get tested during the pandemic. We surveyed an online sample of GBMSM recruited on a gay networking app in China. Among 956 sexually active, 70.1% had received an HIV test in the past 6 months. Among these, 61.0% reported having undergone HIV self-testing (HIVST). Young GBMSM aged 18-24 years old were more likely to receive a recent HIV test, and the number of sexual partners was associated with recent HIV testing [adjusted odds ratio (AOR) = 1.14, 95% confidence interval (CI): 1.03-1.20]. Among those who had a recent HIV test, young GBMSM and those who had anal sex with both main partner and casual partners were more likely to utilize HIVST (AOR = 1.83, 95% CI: 1.16-2.84), as well as GBMSM who did not use a condom the last time engaged in anal sex (AOR = 1.57, 95% CI: 1.06-2.34). Among GBMSM never tested for HIV, a majority perceived low risk of HIV, while some suggested that they did not know where to get tested or they were scared of finding out they had HIV. HIVST has the potential to fill the gap in HIV testing among Chinese GBMSM, and future HIV testing programs should emphasize HIV education, accurate information dissertation, and timely point-to-care services.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin of Public Affairs, Los Angeles, California, USA
| | - Fei Yu
- Danlan Beijing Media Limited, Beijing, China
| | - Hui Xue
- Danlan Beijing Media Limited, Beijing, China
| | - Dapeng Zhang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guodong Mi
- Danlan Beijing Media Limited, Beijing, China
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Simo Fotso A, Johnson C, Vautier A, Kouamé KB, Diop PM, Silhol R, Maheu-Giroux M, Boily MC, Rouveau N, Doumenc-Aïdara C, Baggaley R, Ehui E, Larmarange J. Routine programmatic data show a positive population-level impact of HIV self-testing: the case of Côte d'Ivoire and implications for implementation. AIDS 2022; 36:1871-1879. [PMID: 35848584 PMCID: PMC9594126 DOI: 10.1097/qad.0000000000003328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES We estimate the effects of ATLAS's HIV self-testing (HIVST) kit distribution on conventional HIV testing, diagnoses, and antiretroviral treatment (ART) initiations in Côte d'Ivoire. DESIGN Ecological study using routinely collected HIV testing services program data. METHODS We used the ATLAS's programmatic data recorded between the third quarter of 2019 and the first quarter of 2021, in addition to data from the President's Emergency Plan for AIDS Relief dashboard. We performed ecological time series regression using linear mixed models. Results are presented per 1000 HIVST kits distributed through ATLAS. RESULTS We found a negative but nonsignificant effect of the number of ATLAS' distributed HIVST kits on conventional testing uptake (-190 conventional tests; 95% confidence interval [CI]: -427 to 37). The relationship between the number of HIVST kits and HIV diagnoses was significant and positive (+8 diagnosis; 95% CI: 0 to 15). No effect was observed on ART initiation (-2 ART initiations; 95% CI: -8 to 5). CONCLUSIONS ATLAS' HIVST kit distribution had a positive impact on HIV diagnoses. Despite the negative signal on conventional testing, even if only 20% of distributed kits are used, HIVST would increase access to testing. The methodology used in this paper offers a promising way to leverage routinely collected programmatic data to estimate the effects of HIVST kit distribution in real-world programs.
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Affiliation(s)
- Arlette Simo Fotso
- Centre Population & Développement, Université Paris-Cité, IRD, Inserm, Paris
- French Institute for Demographic Studies, INED, Aubervilliers, France
| | | | - Anthony Vautier
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Dakar, Sénégal
| | | | - Papa Moussa Diop
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Dakar, Sénégal
| | - Romain Silhol
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | - Marie-Claude Boily
- Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom
| | - Nicolas Rouveau
- Centre Population & Développement, Université Paris-Cité, IRD, Inserm, Paris
| | | | | | - Eboi Ehui
- Programme National de Lutte contre le Sida, Abidjan, Côte d’Ivoire
| | - Joseph Larmarange
- Centre Population & Développement, Université Paris-Cité, IRD, Inserm, Paris
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Stephenson R, Sullivan SP, Mitchell JW, Johnson BA, Sullvian PS. Efficacy of a Telehealth Delivered Couples' HIV Counseling and Testing (CHTC) Intervention to Improve Formation and Adherence to Safer Sexual Agreements Among Male Couples in the US: Results from a Randomized Control Trial. AIDS Behav 2022; 26:2813-2824. [PMID: 35194698 PMCID: PMC8863094 DOI: 10.1007/s10461-022-03619-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2022] [Indexed: 12/04/2022]
Abstract
This paper reports the results of a randomized controlled trial (RCT) to assess the efficacy of Nexus, a telehealth delivered intervention that combines Couples' HIV counseling and testing (CHTC) with home-based HIV-testing, examining the impact of the intervention on the couples' formation and adherence to safer sexual agreements. Between 2016 and 2018, 424 couples were recruited online from the U.S and randomized to the intervention arm (a telehealth delivered CHTC session with two home HIV-testing kits) or a control arm (two home HIV-testing kits), with study assessments at baseline, 3 and 6 months. Outcomes were the formation and adherence to safer sexual agreements, dyadic discordance in sexual agreements, breakage of sexual agreements, and perceptions of PrEP. Couples in the intervention arm had significantly greater odds of reporting a safer sexual agreement (3 months OR 1.87, p-value 0.005, and 6 months OR 1.84, p-value 0.007), lower odds of reporting discordant sexual agreements at 6 months (OR 0.62, p-value 0.048), and a significantly lower odds of reporting breaking their sexual agreement (3 months OR 0.51, p-value 0.035, and 6 months OR 0.23, p-value 0.000). By 6 months, couples in the intervention arm were less likely to say PrEP was beneficial to one (RRR 0.33, P = 0.000) or both of them (RRR 0.29, P = 0.000) than being beneficial to neither of the partners. The high levels of acceptability and efficacy of the intervention demonstrate strong potential for the scale-up of this efficacious intervention that is delivered through a low-cost telehealth platform.
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Affiliation(s)
- Rob Stephenson
- The Center for Sexuality and Health Disparities, Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, 400 N Ingalls Street, Ann Arbor, MI, 48109, USA.
| | - Stephen P Sullivan
- The Center for Sexuality and Health Disparities, Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, 400 N Ingalls Street, Ann Arbor, MI, 48109, USA
| | - Jason W Mitchell
- Department of Health Promotion and Disease Prevention, Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Brent A Johnson
- Department of Biostatistics and Computional Biology, University of Rochestor Medical Center, Rochester, NY, USA
| | - Patrick S Sullvian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Rivera A, Martinez P, Braunstein S. Video-based HIV testing services among cisgender men who have sex with men as a component of an HIV behavioural surveillance study during the COVID-19 pandemic in New York City: implementation, feasibility and lessons learned. Sex Transm Infect 2022; 98:310-311. [PMID: 34193531 PMCID: PMC8249171 DOI: 10.1136/sextrans-2021-055110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/09/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Alexis Rivera
- Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Pablo Martinez
- Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Sarah Braunstein
- Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, New York, USA
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9
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Tan RKJ, Wu D, Day S, Zhao Y, Larson HJ, Sylvia S, Tang W, Tucker JD. Digital approaches to enhancing community engagement in clinical trials. NPJ Digit Med 2022; 5:37. [PMID: 35338241 PMCID: PMC8956701 DOI: 10.1038/s41746-022-00581-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/23/2022] [Indexed: 11/11/2022] Open
Abstract
Digital approaches are increasingly common in clinical trial recruitment, retention, analysis, and dissemination. Community engagement processes have contributed to the successful implementation of clinical trials and are crucial in enhancing equity in trials. However, few studies focus on how digital approaches can be implemented to enhance community engagement in clinical trials. This narrative review examines three key areas for digital approaches to deepen community engagement in clinical trials—the use of digital technology for trial processes to decentralize trials, digital crowdsourcing to develop trial components, and digital qualitative research methods. We highlight how digital approaches enhanced community engagement through a greater diversity of participants, and deepened community engagement through the decentralization of research processes. We discuss new possibilities that digital technologies offer for community engagement, and highlight potential strengths, weaknesses, and practical considerations. We argue that strengthening community engagement using a digital approach can enhance equity and improve health outcomes.
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Affiliation(s)
- Rayner K J Tan
- University of North Carolina Project-China, Guangzhou, China. .,Dermatology Hospital of Southern Medical University, Guangzhou, China. .,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Dan Wu
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Suzanne Day
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yang Zhao
- School of Social Science, University of Queensland, Brisbane, QLD, Australia
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Sean Sylvia
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China.,Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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10
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Ferguson L, Narasimhan M, Gutierrez J, Jardell W, Gruskin S. Law, human rights and gender in practice: an analysis of lessons from implementation of self-care interventions for sexual and reproductive health. Sex Reprod Health Matters 2022; 29:2105284. [PMID: 35975874 PMCID: PMC9387312 DOI: 10.1080/26410397.2022.2105284] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Self-care interventions for health are becoming increasingly available, and among the preferred options, including during the COVID-19 pandemic. This research assessed the extent of attention to laws and policies, human rights and gender in the implementation of self-care interventions for sexual and reproductive health (SRH), to identify where additional efforts to ensure an enabling environment for their use and uptake will be useful. A literature review of relevant studies published between 2010 and 2020 was conducted using PubMed, Scopus and Web of Science. Relevant data were systematically abstracted from 61 articles. In March–April 2021, semi-structured interviews were conducted with 10 key informants, selected for their experience implementing self-care interventions for SRH, and thematically analysed. Laws and policies, rights and gender are not being systematically addressed in the implementation of self-care interventions for SRH. Within countries, there is varied attention to the enabling environment including the acceptability of interventions, privacy, informed consent and gender concerns as they impact both access and use of specific self-care interventions, while other legal considerations appear to have been under-prioritised. Operational guidance is needed to develop and implement supportive laws and policies, as well as to ensure the incorporation of rights and gender concerns in implementing self-care interventions for SRH.
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Affiliation(s)
- Laura Ferguson
- Associate Professor of Population and Public Health Sciences, Director of Research, USC Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, USA. Correspondence:
| | - Manjulaa Narasimhan
- Scientist, Department of Sexual and Reproductive Health and Research, World Health Organization, includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction – HRP, Geneva, Switzerland
| | - Jose Gutierrez
- Student, University of Southern California, Los Angeles, CA, USA
| | - William Jardell
- Project Specialist, USC Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, USA
| | - Sofia Gruskin
- Professor of Population and Public Health Sciences and Law, Director, USC Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, USA
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11
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Hamilton DT, Katz DA, Luo W, Stekler JD, Rosenberg ES, Sullivan PS, Goodreau SM, Cassels S. Effective strategies to promote HIV self-testing for men who have sex with men: Evidence from a mathematical model. Epidemics 2021; 37:100518. [PMID: 34775299 PMCID: PMC8759720 DOI: 10.1016/j.epidem.2021.100518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/11/2021] [Accepted: 10/24/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND HIV testing is the gateway to HIV treatment and prevention. HIV self-testing (HIVST) has potential to increase testing; however, the potential population-level impact of HIVST on the HIV epidemic and the best strategies for promoting HIVST are unknown. Our aim is to inform public health approaches for promoting HIVST as part of a comprehensive strategy to reduce HIV incidence. METHODS Stochastic network-based HIV transmission models were used to estimate how different HIVST strategies would affect HIV incidence in Seattle and Atlanta over 10 years. We included four types of HIV testers and implemented nine replacement and eleven supplementation strategies for HIVST. RESULTS Replacement of clinic-based tests with HIVST increased HIV incidence in Seattle and Atlanta. The benefits of supplementary strategies depended on the tester type using HIVST. Targeting non-testers averted the highest number of cases per test. In Seattle 2.2 (95%SI=-77, 100.4) and 4.7 (95%SI=-35.7, 60.1) infections were averted per 1000 HIVST when non-testers used HIVST once or twice per year respectively. In Atlanta the comparable rates were 8.0 (95%SI=-60.3 to 77.7) and 6.7 (95%SI=-37.7, 41.0). Paradoxically, increasing testing among risk-based testers using HIVST increased incidence. CONCLUSIONS The population-level impact of HIVST depends on who is reached with HIVST, how kits are used, and by characteristics of the underlying epidemic and HIV care infrastructure. Targeted HIVST can be an effective component of a comprehensive HIV testing strategy. More work is needed to understand how to identify and target non-testers for self-testing implementation.
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Affiliation(s)
- Deven T Hamilton
- Center for Studies in Demography and Ecology, University of Washington, 206 Raitt Hall, Box 353412, Seattle, WA, United States.
| | - David A Katz
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Wei Luo
- Department of Geography, National University of Singapore, Singapore, Singapore
| | - Joanne D Stekler
- Department of Global Health, University of Washington, Seattle, WA, United States; Department of Medicine, University of Washington, Seattle, WA, United States; Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Eli S Rosenberg
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, NY, United States
| | - Patrick S Sullivan
- Department of Epidemiology, Emory University, Atlanta, GA, UUnited States; Department of Global Health, Emory University, Atlanta, GA, UUnited States
| | - Steven M Goodreau
- Center for Studies in Demography and Ecology, University of Washington, 206 Raitt Hall, Box 353412, Seattle, WA, United States; Department of Anthropology, University of Washington, Seattle, WA, United States
| | - Susan Cassels
- Department of Geography, National University of Singapore, Singapore, Singapore
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12
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Tonen-Wolyec S, Dupont R, Awaida N, Batina-Agasa S, Hayette MP, Bélec L. Evaluation of the Practicability of Biosynex Antigen Self-Test COVID-19 AG+ for the Detection of SARS-CoV-2 Nucleocapsid Protein from Self-Collected Nasal Mid-Turbinate Secretions in the General Public in France. Diagnostics (Basel) 2021; 11:2217. [PMID: 34943454 PMCID: PMC8700066 DOI: 10.3390/diagnostics11122217] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 12/21/2022] Open
Abstract
Due to their ease-of-use, lateral flow assay SARS-CoV-2 antigen-detecting rapid diagnostic tests could be suitable candidates for antigen-detecting rapid diagnostic self-test (Ag-RDST). We evaluated the practicability of the Ag-RDST BIOSYNEX Antigen Self-Test COVID-19 Ag+ (Biosynex Swiss SA, Freiburg, Switzerland), using self-collected nasal secretions from the turbinate medium (NMT), in 106 prospectively included adult volunteers living in Paris, France. The majority of the participants correctly understood the instructions for use (94.4%; 95% confidence interval (CI): 88.3-97.4), showing a great ability to perform the entire self-test procedure to obtain a valid and interpretable result (100%; 95% CI: 96.5-100), and demonstrated the ability to correctly interpret test results (96.2%; 95% CI: 94.2-97.5) with a high level of general satisfaction. About one in eight participants (# 15%) needed verbal help to perform or interpret the test, and only 3.8% of test results were misinterpreted. By reference to multiplex real-time RT-PCR, the Ag-RDST showed 90.9% and 100% sensitivity and specificity, respectively, and high agreement (98.1%), reliability (0.94), and accuracy (90.9%) to detect SARS-CoV-2 antigen. Taken together, our study demonstrates the high usability and accuracy of BIOSYNEX Antigen Self-Test COVID-19 Ag+ for supervised self-collected NMT sampling in an unselected adult population living in France.
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Affiliation(s)
- Serge Tonen-Wolyec
- Ecole Doctorale Régionale D’Afrique Centrale en Infectiologie Tropicale, Franceville 876, Gabon;
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani 2012, Congo;
| | - Raphaël Dupont
- Laboratoire Paris XV, 75015 Paris, France; (R.D.); (N.A.)
| | - Natalio Awaida
- Laboratoire Paris XV, 75015 Paris, France; (R.D.); (N.A.)
| | - Salomon Batina-Agasa
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani 2012, Congo;
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liege, 4000 Liege, Belgium;
| | - Laurent Bélec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, and Université of Paris, Sorbonne Paris Cité, 75015 Paris, France
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13
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Wirtz AL, Naing S, Mon SHH, Paing AZ, Mon EK, Thu KH, M Truong J, Jivapong B, Clouse E, Baral SD, Beyrer C. High acceptability of HIV self-testing in a randomized trial among transgender women and men who have sex with men, Myanmar. AIDS Care 2021; 34:421-429. [PMID: 34802339 DOI: 10.1080/09540121.2021.2005763] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
HIV self-testing (HIVST) shows promise to improve HIV diagnosis among those seeking privacy and anonymity in HIV testing. This may include sexual and gender diverse populations, who experience disproportionately high burdens of stigma and HIV globally. To inform potential scale-up of HIVST in Myanmar, we implemented a community-led, mixed-methods randomized trial in Yangon. Adult trans-feminine individuals and cisgender men who have sex with men were recruited via respondent-driven sampling. Participants (N = 577) completed a baseline survey and were randomized to community-based HIV testing services (HTS) or HIVST. One-third of participants reported lifetime HIV testing. Over half (59.4%) returned for a second study visit to report their test result and test acceptability, which was lower among HTS-assigned participants compared to those assigned to HIVST (55.6% vs. 63.1%; p = 0.096). Participants reported that both HIVST and HTS were easy to access, test, and interpret/understand the results of their HIV test. Ninety percent of HTS-assigned participants indicated they would test regularly if they could access HIVST. Qualitative participants (N = 20) described that the convenience and privacy afforded by HIVST may increase the availability and coverage of testing. Taken together, these results suggest HIVST is an acceptable, low-barrier complement to community-based HTS for key populations in Myanmar.
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Affiliation(s)
- Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MA, USA
| | - Soe Naing
- MAHAMATE (Alliance Myanmar), Yangon, Myanmar
| | - Sandra Hsu Hnin Mon
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MA, USA
| | | | | | | | - Jasmine M Truong
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MA, USA
| | - Belinda Jivapong
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MA, USA
| | - Emily Clouse
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MA, USA
| | - Stefan D Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MA, USA
| | - Chris Beyrer
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MA, USA
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14
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Marley G, Fu G, Zhang Y, Li J, Tucker JD, Tang W, Yu R. Willingness of Chinese Men Who Have Sex With Men to Use Smartphone-Based Electronic Readers for HIV Self-testing: Web-Based Cross-sectional Study. J Med Internet Res 2021; 23:e26480. [PMID: 34806988 PMCID: PMC8663451 DOI: 10.2196/26480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/21/2021] [Accepted: 10/08/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The need for strategies to encourage user-initiated reporting of results after HIV self-testing (HIVST) persists. Smartphone-based electronic readers (SERs) have been shown capable of reading diagnostics results accurately in point-of-care diagnostics and could bridge the current gaps between HIVST and linkage to care. OBJECTIVE Our study aimed to assess the willingness of Chinese men who have sex with men (MSM) in the Jiangsu province to use an SER for HIVST through a web-based cross-sectional study. METHODS From February to April 2020, we conducted a convenience web-based survey among Chinese MSM by using a pretested structured questionnaire. Survey items were adapted from previous HIVST feasibility studies and modified as required. Prior to answering reader-related questions, participants watched a video showcasing a prototype SER. Statistical analysis included descriptive analysis, chi-squared test, and multivariable logistic regression. P values less than .05 were deemed statistically significant. RESULTS Of 692 participants, 369 (53.3%) were aged 26-40 years, 456 (65.9%) had ever self-tested for HIV, and 493 (71.2%) were willing to use an SER for HIVST. Approximately 98% (483/493) of the willing participants, 85.3% (459/538) of ever self-tested and never self-tested, and 40% (46/115) of unwilling participants reported that SERs would increase their HIVST frequency. Engaging in unprotected anal intercourse with regular partners compared to consistently using condoms (adjusted odds ratio [AOR] 3.04, 95% CI 1.19-7.74) increased the odds of willingness to use an SER for HIVST. Participants who had ever considered HIVST at home with a partner right before sex compared to those who had not (AOR 2.99, 95% CI 1.13-7.90) were also more willing to use an SER for HIVST. Playing receptive roles during anal intercourse compared to playing insertive roles (AOR 0.05, 95% CI 0.02-0.14) was associated with decreased odds of being willing to use an SER for HIVST. The majority of the participants (447/608, 73.5%) preferred to purchase readers from local Centers of Disease Control and Prevention offices and 51.2% (311/608) of the participants were willing to pay less than US $4.70 for a reader device. CONCLUSIONS The majority of the Chinese MSM, especially those with high sexual risk behaviors, were willing to use an SER for HIVST. Many MSM were also willing to self-test more frequently for HIV with an SER. Further research is needed to ascertain the diagnostic and real-time data-capturing capacity of prototype SERs during HIVST.
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Affiliation(s)
- Gifty Marley
- School of Public Health, Nanjing Medical University, Nanjing, China.,The Social Entrepreneurship to Spur Health Project, The University of North Carolina Project-China, Guangzhou, China
| | - Gengfeng Fu
- Section of STD/AIDS Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ye Zhang
- Kirby Institute, The University of New South Wales, Sydney, Australia
| | - Jianjun Li
- Section of STD/AIDS Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Joseph D Tucker
- The Social Entrepreneurship to Spur Health Project, The University of North Carolina Project-China, Guangzhou, China.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Weiming Tang
- The Social Entrepreneurship to Spur Health Project, The University of North Carolina Project-China, Guangzhou, China.,Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Rongbin Yu
- School of Public Health, Nanjing Medical University, Nanjing, China
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15
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Oladele D, Iwelunmor J, Gbajabiamila T, Obiezu-Umeh C, Okwuzu JO, Nwaozuru U, Musa AZ, Idigbe I, Tahlil K, Tang W, Conserve DF, Rosenberg NE, David AN, Tucker J, Ezechi O. The 4 Youth By Youth mHealth Photo Verification App for HIV Self-testing in Nigeria: Qualitative Analysis of User Experiences. JMIR Form Res 2021; 5:e25824. [PMID: 34787579 PMCID: PMC8663582 DOI: 10.2196/25824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/31/2021] [Accepted: 08/01/2021] [Indexed: 12/28/2022] Open
Abstract
Background Despite the global expansion of HIV self-testing (HIVST), many research studies still rely on self-reported outcomes. New HIVST verification methods are needed, especially in resource-limited settings. Objective This study aims to evaluate the user experience of a mobile health (mHealth) app to enhance HIVST result reporting and verification. Methods Semistructured, in-depth interviews were used to evaluate the user experience of the 4 Youth By Youth mHealth photo verification app for HIVST. We used a think-aloud approach, and participants performed usability tasks and completed a qualitative exit interview. The app included HIV educational resources, step-by-step video instructions for performing HIVST, a 20-minute timer, a guide on interpreting results with linkages to care, an offline version, and a photo verification system. Demographic characteristics were reported by using descriptive statistics. Qualitative data were analyzed by using thematic analysis. Results A total of 19 users—12 women and 7 men—with a mean age of 22 years, participated in the study. The users completed the usability tasks and successfully uploaded a photo of their test results by using the app without assistance. Four main themes were identified in the data. First, in terms of user-friendly design, the participants noted the user-friendly features of the offline version and the app’s low data use. However, some wanted the app to work in the background when using their mobile phone, and the font used should be more youth friendly. Second, in terms of ease of use, participants remarked that the app’s self-explanatory nature and instructions that guided them on how to use the app enhanced its use. Third, in terms of a user’s privacy, many participants reinforced the importance of privacy settings and tools that protect confidentiality among users. Finally, in terms of linkage to care, participants noted that the app’s linkage to care features were useful, particularly in relation to referrals to trained counselors upon the completion of the test. All the participants noted that the app provided a convenient and private means of verifying the HIV test results. Conclusions Our findings demonstrated the importance of engaging end users in the development phase of health technology innovations that serve youth. Clinical trials are needed to determine the efficacy of using an mHealth app to verify HIVST results among young people.
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Affiliation(s)
- David Oladele
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Juliet Iwelunmor
- Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, MO, United States
| | - Titilola Gbajabiamila
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Chisom Obiezu-Umeh
- Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, MO, United States
| | - Jane Ogoamaka Okwuzu
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Ucheoma Nwaozuru
- Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, MO, United States
| | - Adesola Zaidat Musa
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Ifeoma Idigbe
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Kadija Tahlil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Donaldson F Conserve
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Nora E Rosenberg
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Agatha N David
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joseph Tucker
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill,, NC, United States.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Oliver Ezechi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
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16
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Reipold EI, Farahat A, Elbeeh A, Soliman R, Aza EB, Jamil MS, Johnson CC, Shiha G, Easterbrook P. Usability and acceptability of self-testing for hepatitis C virus infection among the general population in the Nile Delta region of Egypt. BMC Public Health 2021; 21:1188. [PMID: 34158006 PMCID: PMC8218412 DOI: 10.1186/s12889-021-11169-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022] Open
Abstract
Background Self-testing for hepatitis C virus antibodies (HCVST) may be an additional strategy to expand access to hepatitis C virus (HCV) testing and support elimination efforts. We conducted a study to assess the usability and acceptability of HCVST among the general population in a semi-rural, high-HCV prevalence region in Egypt. Methods An observational study was conducted in two hospitals in the Nile Delta region. A trained provider gave an in-person demonstration on how to use the oral fluid HCVST followed by observation of the participant performing the test. Usability was assessed by observing errors made and difficulties faced by participants. Acceptability of HCV self-testing was assessed using an interviewer-administered semi-structured questionnaire. Results Of 116 participants enrolled, 17 (14.6%) had received no formal education. The majority (72%) of participants completed all testing steps without any assistance and interpreted the test results correctly. Agreement between participant-reported HCVST results and interpretation by a trained user was 86%, with a Cohen’s kappa of 0.6. Agreement between participant-reported HCVST results and provider-administered oral fluid HCV rapid test results was 97.2%, with a Cohen’s kappa of 0.75. The majority of participants rated the HCVST process as easy (53%) or very easy (44%), and 96% indicated they would be willing to use HCVST again and recommend it to their family and friends. Conclusion Our study demonstrates the high usability and acceptability of oral fluid HCVST in a general population. Further studies are needed to establish the optimal positioning of self-testing alongside facility-based testing to expand access to HCV diagnosis in both general and high-risk populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11169-x.
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Affiliation(s)
| | - Ahmed Farahat
- Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt
| | - Amira Elbeeh
- Association of Liver Patient Care (ALPC), Mansoura, Egypt
| | - Reham Soliman
- Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt.,Tropical Medicine Department, Port Said University, Port Said, Egypt
| | | | - Muhammad S Jamil
- Department of Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Cheryl Case Johnson
- Department of Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
| | - Gamal Shiha
- Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt.,Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - Philippa Easterbrook
- Department of Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland
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17
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Majam M, Msolomba V, Scott L, Stevens W, Marange F, Kahamba T, Venter F, Conserve DF. Self-Sampling for SARS-CoV-2 Diagnostic Testing by Using Nasal and Saliva Specimens: Protocol for Usability and Clinical Evaluation. JMIR Res Protoc 2021; 10:e24811. [PMID: 33882023 PMCID: PMC8166267 DOI: 10.2196/24811] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 03/02/2021] [Accepted: 03/09/2021] [Indexed: 01/02/2023] Open
Abstract
Background SARS-CoV-2 is a novel coronavirus discovered in December 2019 and is currently the cause of the global COVID-19 pandemic. A critical aspect of fighting this pandemic is to obtain accurate and timely test results so that patients who have tested positive for COVID-19 can be identified and isolated to reduce the spread of the virus. Research has shown that saliva is a promising candidate for SARS-CoV-2 diagnostics because its collection is minimally invasive and can be reliably self-administered. However, little research has been conducted on saliva testing and SARS-CoV-2 self-sampling (SARS-CoV-2SS) in Sub-Saharan Africa. Objective The primary objective of this study is to comparatively evaluate the clinical sensitivity and specificity of nasal and oral samples self-collected by individuals for SARS-CoV-2 testing against a reference method involving sample collection and testing by a health care professional. The secondary objectives of this study are to evaluate the usability of nasal self-sampling and saliva self-sampling as a sample collection method for SARS-CoV-2 diagnostic testing by using failure mode and error assessment. Methods Participants will be recruited from the general population by using various methods, Participants will be screened progressively as they present at the clinical trial sites as well as in primary health care catchment areas in the inner city of Johannesburg, South Africa. In the event that recruitment numbers are low, we will use a mobile van to recruit participants from outlying areas of Johannesburg. We aim to enroll 250 participants into this study in approximately 6 weeks. Two sample types—a self-administered nasal swab and a self-administered saliva sample—will be collected from each participant, and a health care professional will collect a third sample by using a nasopharyngeal swab (ie, the standard reference method). Results This protocol has been approved by the University of the Witwatersrand Human Research Ethics Committee on July 31, 2020 (Protocol number EzCov003). As of May 13, 2021, 120 participants have been enrolled into the study. Conclusions SARS-CoV-2SS may offer many benefits to individuals, by allowing for initial self-identification of symptoms and collection of samples without involving third parties and potential risk of infection provided the sample can be safely processed via a collection system. The results of this study will provide preliminary data on the acceptability, feasibility, and usability of SARS-CoV-2SS among the general population for its future implementation. International Registered Report Identifier (IRRID) DERR1-10.2196/24811
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Affiliation(s)
- Mohammed Majam
- Ezintsha, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa
| | - Vanessa Msolomba
- Ezintsha, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa
| | - Lesley Scott
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
| | - Wendy Stevens
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
| | - Fadzai Marange
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
| | - Trish Kahamba
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
| | - Francois Venter
- Ezintsha, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa
| | - Donaldson Fadael Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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18
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Self-testing for HIV, HBV, and HCV using finger-stick whole-blood multiplex immunochromatographic rapid test: A pilot feasibility study in sub-Saharan Africa. PLoS One 2021; 16:e0249701. [PMID: 33836036 PMCID: PMC8034751 DOI: 10.1371/journal.pone.0249701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/24/2021] [Indexed: 11/20/2022] Open
Abstract
Background The burden of HIV, HBV, and HCV infections remains disproportionately high in sub-Saharan Africa, with high rates of co-infections. Multiplex rapid diagnostic tests for HIV, HBV and HCV serological testing with high analytical performances may improve the “cascade of screening” and quite possibly the linkage-to-care with reduced cost. Based on our previous field experience of HIV self-testing, we herein aimed at evaluating the practicability and acceptability of a prototype finger-stick whole-blood Triplex HIV/HCV/HBsAg self-test as a simultaneous serological screening tool for HIV, HBV, and HCV in the Democratic Republic of the Congo (DRC). Methods A cross-sectional multicentric study consisting of face-to-face, paper-based, and semi-structured questionnaires with a home-based and facility-based recruitment of untrained adult volunteers at risk of HIV, HBV, and HCV infections recruited from the general public was conducted in 2020 in urban and rural areas in the DRC. The practicability of the Triplex self-test was assessed by 3 substudies on the observation of self-test manipulation including the understanding of the instructions for use (IFU), on the interpretation of Triplex self-test results and on its acceptability. Results A total of 251 volunteers (mean age, 28 years; range, 18–49; 154 males) were included, from urban [160 (63.7%)] and rural [91 (36.3%)] areas. Overall, 242 (96.4%) participants performed the Triplex self-test and succeeded in obtaining a valid test result with an overall usability index of 89.2%. The correct use of the Triplex self-test was higher in urban areas than rural areas (51.2% versus 16.5%; aOR: 6.9). The use of video IFU in addition to paper-based IFU increased the correct manipulation and interpretation of the Triplex self-test. A total of 197 (78.5%) participants correctly interpreted the Triplex self-test results, whereas 54 (21.5%) misinterpreted their results, mainly the positive test results harboring low-intensity band (30/251; 12.0%), and preferentially the HBsAg band (12/44; 27.3%). The rates of acceptability of reuse, distribution of the Triplex self-test to third parties (partner, friend, or family member), linkage to the health care facility for confirmation of results and treatment, and confidence in the self-test results were very high, especially among participants from urban areas. Conclusions This pilot study shows evidence for the first time in sub-Saharan Africa on good practicability and high acceptability of a prototype Triplex HIV/HCV/HBsAg self-test for simultaneous diagnosis of three highly prevalent chronic viral infections, providing the rational basis of using self-test harboring four bands of interest, i.e. the control, HIV, HCV, and HBsAg bands. The relatively frequent misinterpretation of the Triplex self-test points however the necessity to improve the delivery of this prototype Triplex self-test probably in a supervised setting. Finally, these observations lay the foundations for the potential large-scale use of the Triplex self-test in populations living in sub-Saharan Africa at high risk for HIV, HBV, and HCV infections.
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19
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Ballard AM, Haardöerfer R, Prood N, Mbagwu C, Cooper HLF, Young AM. Willingness to Participate in At-Home HIV Testing Among Young Adults Who Use Opioids in Rural Appalachia. AIDS Behav 2021; 25:699-708. [PMID: 32910353 PMCID: PMC7481760 DOI: 10.1007/s10461-020-03034-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
New HIV infections associated with injection drug use are of major concern in rural US communities. This study explores acceptability of, consent for, and uptake of free at-home HIV testing among people who use drugs (PWUD) in one of the nation’s epicenters for drug-related harms and HIV vulnerability: Rural Central Appalachia. Eligible participants were 18–35 years old, lived in Appalachian Kentucky, and reported using opioids to get high in the previous 30 days. A majority reported being likely (63.6%, 96/151) to take a free at-home HIV tests and 66.9% (101/151) consented to receive one. Among those who were randomly selected to receive a Home Access HIV-1 test kit (n = 37), 37.8% mailed in blood spots and 21.6% called to receive results. This study provides evidence that PWUD may be willing to take an at-home test, but other barriers may inhibit actual completion.
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Affiliation(s)
- April M Ballard
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, USA.
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30329, USA.
| | - Regine Haardöerfer
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Nadya Prood
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Chukwudi Mbagwu
- Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington, KY, USA
| | - Hannah L F Cooper
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - April M Young
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington, KY, USA
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
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Obiezu-Umeh C, Gbajabiamila T, Ezechi O, Nwaozuru U, Ong JJ, Idigbe I, Oladele D, Musa AZ, Uzoaru F, Airhihenbuwa C, Tucker JD, Iwelunmor J. Young people's preferences for HIV self-testing services in Nigeria: a qualitative analysis. BMC Public Health 2021; 21:67. [PMID: 33413246 PMCID: PMC7792110 DOI: 10.1186/s12889-020-10072-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 12/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV self-testing (HIVST) provides young people with a convenient, discreet, and empowering way to know their HIV status. However, there is limited knowledge of young people's preferences for HIVST services and potential factors that may influence the uptake of HIVST among this population. The purpose of this research was to use qualitative methods to examine HIVST preferences among Nigerian youth. METHODS Semi-structured in-depth interviews with a purposive sample of young people 14-24 years old were conducted in Lagos, Nigeria. Data were analyzed thematically to identify themes and domains related to preferences and factors influencing the use of HIV self-testing. RESULTS A total of 65 youth with mean age of 21 years, were interviewed, and the majority were females (56%). Four themes emerged as the most important characteristics that may influence young people's preferences for HIV self-testing: 1) Cost (i.e. majority of participants noted that they would pay between NGN500 to NGN1,500 naira (USD1.38-USD4.16) for oral HIV self-testing kits); 2) Testing method (i.e. although blood-based sample kits were more popular than oral-based self-testing kits, most preferred the oral-based option due to its perceived benefits and for some, phobia of needles); 3) Access location (i.e. participants suggested they preferred to obtain the HIVST kits from youth-friendly centers, pharmacies, private health facilities, and online stores); and 4) Continuing care and support (i.e. participants highlighted the importance of linkage to care with trained youth health workers for positive or negative test results or toll-free helpline). CONCLUSION HIV self-testing preferences among Nigerian youth appear to be influenced by several factors including lower cost, less invasive testing method, location of testing, and linkage to care and support post testing. Findings underscore the need to address young people's HIV self-testing preferences as a foundation for implementing programs and research to increase the uptake of HIVST.
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Affiliation(s)
- Chisom Obiezu-Umeh
- College for public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
| | - Titilola Gbajabiamila
- Department of Clinical Sciences National Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Oliver Ezechi
- Department of Clinical Sciences National Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Ucheoma Nwaozuru
- College for public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Jason J Ong
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Central Clinical School, Monash University, Clayton, Australia
| | - Ifeoma Idigbe
- Department of Clinical Sciences National Institute of Medical Research, Yaba, Lagos, Nigeria
| | - David Oladele
- Department of Clinical Sciences National Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Adesola Z Musa
- Department of Clinical Sciences National Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Florida Uzoaru
- College for public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | | | - Joseph D Tucker
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Juliet Iwelunmor
- College for public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
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21
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Biello KB, Horvitz C, Mullin S, Mayer KH, Scott H, Coleman K, Dormitzer J, Norelli J, Hightow-Weidman L, Sullivan P, Mimiaga MJ, Buchbinder S, Bojan K, Futterman D, Emmanuel P, Liu A. HIV self-testing and STI self-collection via mobile apps: experiences from two pilot randomized controlled trials of young men who have sex with men. Mhealth 2021; 7:26. [PMID: 33898595 PMCID: PMC8063023 DOI: 10.21037/mhealth-20-70] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/15/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Young men who have sex with men (YMSM) are disproportionately impacted by HIV and other sexually transmitted infections (STIs) in the United States (US) and have low rates of HIV/STI testing. Provision of HIV self-testing and STI self-collection can increase testing rates, and access to these kits through mobile applications (apps) could help facilitate YMSM using HIV self-testing and STI self-collection. METHODS Data for this study comes from two pilot randomized controlled trials (RCTs) of mobile apps within the Adolescent Trials Network-LYNX and MyChoices-aimed to increase HIV/STI testing among YMSM (age 15-24) who had not recently tested for HIV and were at high risk for HIV acquisition across five US cities. Both apps include the ability to order a HIV self-test with rapid results and a kit for STI self-collection and mailing of samples for syphilis, gonorrhea and chlamydia to a lab for testing. Using assessments of app users (n=80) at pre-randomization and at 3- and 6-months post-randomization and online interview data from a purposive sample of app users (n=37), we report on experiences and lessons learned with HIV self-testing and STI self-collection kits ordered via the apps. RESULTS Participants were on average 20.7 years of age (SD =2.4), and 49% were non-White or multiple race/ethnicity. Sixty-three percent had a prior HIV test. Over half (58%) had a prior STI test, but only 3% had tested within the past 3 months. Nearly two-thirds ordered an HIV self-testing kit; of whom, 75% reported using at least one self-test kit over the study period. STI self-collection kit ordering rates were also high (54%); however, STI self-collection kit return rates were lower (13%), but with a high positivity rate (5.3%). Both HIV self-testing and STI self-collection kits were highly acceptable, and 87% reported that it was extremely/very helpful to be able to order these kits through the apps. The most common reason for not ordering the HIV/STI kits was preferring to test at a clinic. In interviews, participants expressed feeling empowered by being able to test at home; however, they also raised concerns around STI sample collection. CONCLUSIONS HIV self-testing and STI self-collection kit ordering via mobile apps is feasible, acceptable and may show promise in increasing testing rates among YMSM. The LYNX and MyChoices apps are currently being tested in a full-scale efficacy trial, and if successful, these innovative mobile apps could be scaled up to efficiently increase HIV/STI testing among youth across the US.
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Affiliation(s)
- Katie B. Biello
- Departments of Behavioral & Social Health Sciences and Epidemiology, School of Public Health, Brown University, Providence, RI, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
| | - Casey Horvitz
- Institute for Global Health & Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Shelby Mullin
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kenneth H. Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Global Health and Population, Harvard T.C. Chan School of Public Health, Boston, MA, USA
- Department of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Hyman Scott
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA
- University of California, San Francisco, CA, USA
| | - Kenneth Coleman
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA
| | | | - Jenna Norelli
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lisa Hightow-Weidman
- Institute for Global Health & Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Patrick Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Matthew J. Mimiaga
- Departments of Behavioral & Social Health Sciences and Epidemiology, School of Public Health, Brown University, Providence, RI, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - Susan Buchbinder
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA
- University of California, San Francisco, CA, USA
| | - Kelly Bojan
- Division of Adolescent Medicine, The Ruth M. Rothstein CORE Center, Chicago, IL, USA
| | - Donna Futterman
- Adolescent AIDS Program, Children’s Hospital at Montefiore, Bronx, NY, USA
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Patricia Emmanuel
- Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Albert Liu
- Bridge HIV, San Francisco Department of Public Health, San Francisco, CA, USA
- University of California, San Francisco, CA, USA
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22
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Conserve DF, Mathews A, Choko AT, Nelson LE. Preparing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Self-Testing Implementation: Lessons Learned From HIV Self-Testing. Front Med (Lausanne) 2020; 7:599521. [PMID: 33365320 PMCID: PMC7750534 DOI: 10.3389/fmed.2020.599521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/19/2020] [Indexed: 01/24/2023] Open
Affiliation(s)
- Donaldson F. Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Allison Mathews
- Maya Angelou Center for Health Equity, Wake Forest Baptist Medical Center, Winston-Salem, NC, United States
| | - Augustine T. Choko
- Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - LaRon E. Nelson
- Yale School of Nursing, Orange, CA, United States
- Unity Health Toronto, St. Michael's Hospital, MAP Centre for Urban Health Solutions, Toronto, ON, Canada
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23
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Tonen-Wolyec S, Dupont R, Batina-Agasa S, Hayette MP, Bélec L. Capillary whole-blood IgG-IgM COVID-19 self-test as a serological screening tool for SARS-CoV-2 infection adapted to the general public. PLoS One 2020; 15:e0240779. [PMID: 33057446 PMCID: PMC7561138 DOI: 10.1371/journal.pone.0240779] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/03/2020] [Indexed: 01/08/2023] Open
Abstract
The practicability of a prototype capillary whole-blood IgG-IgM COVID-19 self-test (Exacto® COVID-19 self-test, Biosynex Swiss SA, Freiburg, Switzerland) as a serological screening tool for SARS-CoV-2 infection adapted to the general public was evaluated in a cross-sectional, general adult population study performed between April and May 2020 in Strasbourg, France, consisting of face-to-face, paper-based, semi-structured, and self-administrated questionnaires. Practicability was defined as the correct use of the self-test and the correct interpretation of the result. The correct use of self-test was conditioned by the presence of the control band after 15-min of migration. The correct interpretation of the tests was defined by the percent agreement between the tests results read and interpret by the participants compared to the expected results coded by the numbers and verified by trained observers. A total of 167 participants (52.7% female; median age, 35.8 years; 82% with post-graduate level) were enrolled, including 83 and 84 for usability and test results interpretation substudies, respectively. All participants (100%; 95% CI: 95.6-100) correctly used the self-test. However, 12 (14.5%; 95% CI: 8.5-23.6) asked for verbal help. The percent agreement between the tests results read and interpret by the participants compared to the expected results was 98.5% (95% CI: 96.5-99.4). However, misinterpretation occurred in only 2.3% of positive and 1.2% of invalid test results. Finally, all (100%) participants found that performing the COVID-19 self-test was easy; and 98.8% found the interpretation of the self-test results easy. Taken together, these pilot observations demonstrated for the first-time, high practicability and satisfaction of COVID-19 self-testing for serological IgG and IgM immune status, indicating its potential for use by the general public to complete the arsenal of available SARS-CoV-2 serological assays in the urgent context of the COVID-19 epidemic.
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Affiliation(s)
- Serge Tonen-Wolyec
- Ecole Doctorale Régionale D’Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, The Democratic Republic of the Congo
| | | | - Salomon Batina-Agasa
- Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, The Democratic Republic of the Congo
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liège, Liege, Belgium
| | - Laurent Bélec
- Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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