Supervised and unsupervised self-testing for HIV in high-and low-risk populations: a systematic review

 

Show simple item record

dc.contributor.author Pai, Nitika Pant en_ZA
dc.contributor.author Sharma, Jigyasa en_ZA
dc.contributor.author Shivkumar, Sushmita en_ZA
dc.contributor.author Pillay, Sabrina en_ZA
dc.contributor.author Vadnais, Caroline en_ZA
dc.contributor.author Joseph, Lawrence en_ZA
dc.contributor.author Dheda, Keertan en_ZA
dc.contributor.author Peeling, Rosanna W en_ZA
dc.date.accessioned 2016-01-11T06:51:39Z
dc.date.available 2016-01-11T06:51:39Z
dc.date.issued 2013 en_ZA
dc.identifier.citation Pai, N. P., Sharma, J., Shivkumar, S., Pillay, S., Vadnais, C., Joseph, L., ... & Peeling, R. W. (2013). Supervised and unsupervised self-testing for HIV in high-and low-risk populations: a systematic review. PLoS Med, 10(4), e1001414. doi:10.1371/journal.pmed.1001414 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16252
dc.identifier.uri http://dx.doi.org/10.1371/journal.pmed.1001414
dc.description.abstract Background: Stigma, discrimination, lack of privacy, and long waiting times partly explain why six out of ten individuals living with HIV do not access facility-based testing. By circumventing these barriers, self-testing offers potential for more people to know their sero-status. Recent approval of an in-home HIV self-test in the US has sparked self-testing initiatives, yet data on acceptability, feasibility, and linkages to care are limited. We systematically reviewed evidence on supervised (self-testing and counselling aided by a health care professional) and unsupervised (performed by self-tester with access to phone/internet counselling) self-testing strategies. Methods and Findings: Seven databases (Medline [via PubMed], Biosis, PsycINFO, Cinahl, African Medicus, LILACS, and EMBASE) and conference abstracts of six major HIV/sexually transmitted infections conferences were searched from 1st January 2000–30th October 2012. 1,221 citations were identified and 21 studies included for review. Seven studies evaluated an unsupervised strategy and 14 evaluated a supervised strategy. For both strategies, data on acceptability (range: 74%–96%), preference (range: 61%–91%), and partner self-testing (range: 80%–97%) were high. A high specificity (range: 99.8%–100%) was observed for both strategies, while a lower sensitivity was reported in the unsupervised (range: 92.9%–100%; one study) versus supervised (range: 97.4%–97.9%; three studies) strategy. Regarding feasibility of linkage to counselling and care, 96% (n = 102/106) of individuals testing positive for HIV stated they would seek post-test counselling (unsupervised strategy, one study). No extreme adverse events were noted. The majority of data (n = 11,019/12,402 individuals, 89%) were from high-income settings and 71% (n = 15/21) of studies were cross-sectional in design, thus limiting our analysis. Conclusions: Both supervised and unsupervised testing strategies were highly acceptable, preferred, and more likely to result in partner self-testing. However, no studies evaluated post-test linkage with counselling and treatment outcomes and reporting quality was poor. Thus, controlled trials of high quality from diverse settings are warranted to confirm and extend these findings. 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 Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLOS Medicince en_ZA
dc.source.uri http://journals.plos.org/plosmedicine en_ZA
dc.subject.other HIV en_ZA
dc.subject.other HIV diagnosis and management en_ZA
dc.subject.other HIV infections en_ZA
dc.subject.other Qualitative studies en_ZA
dc.subject.other AIDS en_ZA
dc.subject.other Internet en_ZA
dc.subject.other Malawi en_ZA
dc.subject.other Spain en_ZA
dc.title Supervised and unsupervised self-testing for HIV in high-and low-risk populations: a systematic review 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


Files in this item

This item appears in the following Collection(s)

Show simple item record

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.