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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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Wango GN, Agot K, Ogolla H, Ochillo M, Ohaga S, Thirumurthy H. Adolescent girls' perception about their ability to safely offer HIV self-test kits to sexual partners: a feasibility study in Siaya County, Kenya. Afr Health Sci 2021; 21:1059-1066. [PMID: 35222567 PMCID: PMC8843252 DOI: 10.4314/ahs.v21i3.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Adolescent girls (AG) in sub-Saharan Africa are at elevated risk of acquiring HIV, yet few know the HIV status of their sexual partners. Interventions to promote testing among partners are urgently needed. Objectives To explore AG's perceived ability to safely distribute HIV self-tests to their partners, if partners would self-test, and how to minimize partner violence. Methods We recruited HIV-negative AG ages 15–19 years with a partner of unknown HIV status or who tested negative >6 months previously. Using mixed-methods for data collection and regression and inductive thematic analysis for quantitative and qualitative analysis, respectively, we determined factors associated with the study objectives. Results We enrolled 101 AG, median age 17.3 years, sexual debut 15–16 years, and 54.5% reported ≥2 lifetime partners. Most participants (95.0%) would offer self-tests to their partners and 95.1% reported high-to-moderate chance their partner would self-test. No participant attribute was associated with perceived ability to offer self-test or likelihood of partner testing. To avoid violence, AG recommended politeness, indirect approach, voluntariness, and highlighting advantages of self-testing. Conclusions AG believe they can safely distribute self-tests to their partners, and most partners would self-test, expanding utility of HIV self-tests to include partners of AG.
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Affiliation(s)
- Gift-Noelle Wango
- Nyanza Initiative for Girls Education and Empowerment, Kisumu, Kenya
| | - Kawango Agot
- Impact Research and Development Organization, Kisumu, Kenya
| | - Henry Ogolla
- Impact Research and Development Organization, Kisumu, Kenya
| | | | - Spala Ohaga
- Impact Research and Development Organization, Kisumu, Kenya
| | - Harsha Thirumurthy
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
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Christian SN, Mantell JE, Romo ML, Grov C, George G, Mwai E, Nyaga E, Odhiambo JO, Govender K, Kelvin EA. Applying a social-ecological lens to opinions about HIV self-testing among Kenyan truckers who declined to test: a qualitative study. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2020; 19:147-155. [PMID: 32780676 DOI: 10.2989/16085906.2020.1764070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
HIV prevalence among truckers in Africa is high and testing rates suboptimal. With numerous African countries having approved HIV self-testing kits, more information on how to design acceptable and accessible self-testing programs for high-risk populations is necessary. We explored views about self-testing via in-depth interviews with 24 truckers participating in a randomised controlled trial who refused HIV testing. A social-ecological lens was used to guide data analysis and frame study findings. While most participants said that they would use an HIV self-test, perceived barriers and facilitators were identified at multiple levels. Many participants noted lack of time to test or obtain a self-test kit as a major barrier (intrapersonal) and varied in their views about self-testing with a partner (interpersonal). Participants offered programmatic/policy recommendations, suggesting that they preferred accessing self-test kits in settings where training could be provided. Participants believed they should be able to pick up multiple test kits at the same time and that the test kits should be free or low cost. These study findings will help guide the design of self-testing programs for truckers and other mobile populations.
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Affiliation(s)
- Stephanie N Christian
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, USA
| | - Joanne E Mantell
- HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Division of Gender, Sexuality and Health, New York State Psychiatric Institute & Columbia University, New York, USA
| | - Matthew L Romo
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, USA.,CUNY Institute for Implementation Science in Population Health, City University of New York, New York, USA
| | - Christian Grov
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, USA.,CUNY Institute for Implementation Science in Population Health, City University of New York, New York, USA
| | - Gavin George
- Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
| | - Eva Mwai
- North Star Alliance, Nairobi, Kenya
| | | | | | - Kaymarlin Govender
- Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
| | - Elizabeth A Kelvin
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, USA
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