Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study

 

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dc.contributor.author Pai, Nitika Pant en_ZA
dc.contributor.author Behlim, Tarannum en_ZA
dc.contributor.author Abrahams, Lameze en_ZA
dc.contributor.author Vadnais, Caroline en_ZA
dc.contributor.author Shivkumar, Sushmita en_ZA
dc.contributor.author Pillay, Sabrina en_ZA
dc.contributor.author Binder, Anke en_ZA
dc.contributor.author Deli-Houssein, Roni en_ZA
dc.contributor.author Engel, Nora en_ZA
dc.contributor.author Joseph, Lawrence en_ZA
dc.contributor.author Dheda, Keertan en_ZA
dc.date.accessioned 2016-01-11T06:51:37Z
dc.date.available 2016-01-11T06:51:37Z
dc.date.issued 2013 en_ZA
dc.identifier.citation Pant, P. N., Behlim, T., Abrahams, L., Vadnais, C., Shivkumar, S., Pillay, S., ... & Dheda, K. (2012). Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study. PloS one, 8(11), e79772. doi:10.1371/journal.pone.0079772 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16249
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0079772
dc.description.abstract BACKGROUND: In South Africa, stigma, discrimination, social visibility and fear of loss of confidentiality impede health facility-based HIV testing. With 50% of adults having ever tested for HIV in their lifetime, private, alternative testing options are urgently needed. Non-invasive, oral self-tests offer a potential for a confidential, unsupervised HIV self-testing option, but global data are limited. METHODS: A pilot cross-sectional study was conducted from January to June 2012 in health care workers based at the University of Cape Town, South Africa. An innovative, unsupervised, self-testing strategy was evaluated for feasibility; defined as completion of self-testing process (i.e., self test conduct, interpretation and linkage). An oral point-of-care HIV test, an Internet and paper-based self-test HIV applications, and mobile phones were synergized to create an unsupervised strategy. Self-tests were additionally confirmed with rapid tests on site and laboratory tests. Of 270 health care workers (18 years and above, of unknown HIV status approached), 251 consented for participation. FINDINGS: Overall, about 91% participants rated a positive experience with the strategy. Of 251 participants, 126 evaluated the Internet and 125 the paper-based application successfully; completion rate of 99.2%. All sero-positives were linked to treatment (completion rate:100% (95% CI, 66.0-100). About half of sero-negatives were offered counselling on mobile phones; completion rate: 44.6% (95% CI, 38.0-51.0). A majority of participants (78.1%) were females, aged 18-24 years (61.4%). Nine participants were found sero-positive after confirmatory tests (prevalence 3.6% 95% CI, 1.8-6.9). Six of nine positive self-tests were accurately interpreted; sensitivity: 66.7% (95% CI, 30.9-91.0); specificity:100% (95% CI, 98.1-100). Interpretation Our unsupervised self-testing strategy was feasible to operationalize in health care workers in South Africa. Linkages were successfully operationalized with mobile phones in all sero-positives and about half of the sero-negatives sought post-test counselling. Controlled trials and implementation research studies are needed before a scale-up is considered. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the <a href= en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other HIV en_ZA
dc.subject.other HIV infections en_ZA
dc.subject.other Internet en_ZA
dc.subject.other Cell phones en_ZA
dc.subject.other Nurses en_ZA
dc.subject.other Pilot studies en_ZA
dc.subject.other Sexually transmitted diseases en_ZA
dc.subject.other HIV diagnosis and management en_ZA
dc.title Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2013 Pant Pai et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Pulmonology en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Pai, N. P., Behlim, T., Abrahams, L., Vadnais, C., Shivkumar, S., Pillay, S., ... Dheda, K. (2013). Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study. <i>PLoS One</i>, http://hdl.handle.net/11427/16249 en_ZA
dc.identifier.chicagocitation Pai, Nitika Pant, Tarannum Behlim, Lameze Abrahams, Caroline Vadnais, Sushmita Shivkumar, Sabrina Pillay, Anke Binder, et al "Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study." <i>PLoS One</i> (2013) http://hdl.handle.net/11427/16249 en_ZA
dc.identifier.vancouvercitation Pai NP, Behlim T, Abrahams L, Vadnais C, Shivkumar S, Pillay S, et al. Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study. PLoS One. 2013; http://hdl.handle.net/11427/16249. en_ZA
dc.identifier.ris TY - Journal Article AU - Pai, Nitika Pant AU - Behlim, Tarannum AU - Abrahams, Lameze AU - Vadnais, Caroline AU - Shivkumar, Sushmita AU - Pillay, Sabrina AU - Binder, Anke AU - Deli-Houssein, Roni AU - Engel, Nora AU - Joseph, Lawrence AU - Dheda, Keertan AB - BACKGROUND: In South Africa, stigma, discrimination, social visibility and fear of loss of confidentiality impede health facility-based HIV testing. With 50% of adults having ever tested for HIV in their lifetime, private, alternative testing options are urgently needed. Non-invasive, oral self-tests offer a potential for a confidential, unsupervised HIV self-testing option, but global data are limited. METHODS: A pilot cross-sectional study was conducted from January to June 2012 in health care workers based at the University of Cape Town, South Africa. An innovative, unsupervised, self-testing strategy was evaluated for feasibility; defined as completion of self-testing process (i.e., self test conduct, interpretation and linkage). An oral point-of-care HIV test, an Internet and paper-based self-test HIV applications, and mobile phones were synergized to create an unsupervised strategy. Self-tests were additionally confirmed with rapid tests on site and laboratory tests. Of 270 health care workers (18 years and above, of unknown HIV status approached), 251 consented for participation. FINDINGS: Overall, about 91% participants rated a positive experience with the strategy. Of 251 participants, 126 evaluated the Internet and 125 the paper-based application successfully; completion rate of 99.2%. All sero-positives were linked to treatment (completion rate:100% (95% CI, 66.0-100). About half of sero-negatives were offered counselling on mobile phones; completion rate: 44.6% (95% CI, 38.0-51.0). A majority of participants (78.1%) were females, aged 18-24 years (61.4%). Nine participants were found sero-positive after confirmatory tests (prevalence 3.6% 95% CI, 1.8-6.9). Six of nine positive self-tests were accurately interpreted; sensitivity: 66.7% (95% CI, 30.9-91.0); specificity:100% (95% CI, 98.1-100). Interpretation Our unsupervised self-testing strategy was feasible to operationalize in health care workers in South Africa. Linkages were successfully operationalized with mobile phones in all sero-positives and about half of the sero-negatives sought post-test counselling. Controlled trials and implementation research studies are needed before a scale-up is considered. DA - 2013 DB - OpenUCT DO - 10.1371/journal.pone.0079772 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study TI - Will an unsupervised self-testing strategy for HIV work in health care workers of South Africa? A cross sectional pilot feasibility study UR - http://hdl.handle.net/11427/16249 ER - en_ZA


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