Uptake of HIV testing remains low among men in South Africa. As part of a trial, we assessed the acceptability of a theoretically derived and adapted tablet-based-application (EPIC-HIV1) in rural South Africa. We conducted 20 in-depth interviews with men aged ≥18 years and offered a tablet-based survey to all men aged ≥15 years who received EPIC-HIV1 (Sep-Dec 2018). We conducted a descriptive analysis of the survey and used Self-Determination Theory (SDT) to guide our thematic analysis. A total of 232/307 (75%) completed the survey, 55% of whom were aged 15-24 years. 96%[ CI: 92.8-98.2%; n = 223] found EPIC-HIV1 acceptable and 77% [95% CI: 71.8-82.6%; n = 179] found it user-friendly. 222 [96%] reported that EPIC-HIV1 motivated them to test; 83% (192/232) tested for HIV, of which 33% (64/192) were first time testers. Those who did not consent (n = 40) were more likely to have had an HIV-positive test result. Participants reported that the app boosted their confidence to test. However, they were unsure that the app would help them overcome barriers to test in local clinics. Given reach and usability, an adapted SDT male-tailored app was found to be acceptable and could encourage positive health-seeking behavioural change among men.
Methods A comprehensive search of published studies was carried out in six electronic databases followed by a manual search of studies from references of selected papers. Data were extracted using a template. The results were synthesised, and a meta-analysis based on a random-effects model was conducted. Subgroup and sensitivity analyses were undertaken to explore sources of heterogeneity. Results Of 30,273 citations, 14 studies with a total of 97,030 study participants were identified. The pooled CHTC uptake was 31.48% (95%CI: 23.55-40.00) with significant heterogeneity between studies (I 2 =99.98%, p < 0.001). The Egger's and Begg's tests showed there was no evidence of publication bias (p=0.08). However, the sensitivity analysis showed that two studies highly influenced the overall estimate. After omitting these two studies, the pooled estimate for CHTC uptake was 24.05% (95%CI: 16.6 5, 32.34, I 2 =99.86%, p<0.001). The sub-group analysis indicated the pooled CHTC uptake was higher among pregnant women and their partners (OR=1.66, 95%CI: 1.58, 1.84) compared with heterosexual couples in general. Similarly, the uptake was higher when one person in the dyad first tested individually without the knowledge of their partner, and then suggested to their partner that they take CHTC together, compared to an approach of undertaking CHTC together as the first testing option for both people (OR=3.16, 95%CI: 2.69, 3.72). Conclusion The findings confirmed that more than three-quarters of study participants who were in ongoing heterosexual relationships chose not to, or were unable to, undertake CHTC. These findings suggest people are cautious of what could amount to harmful risks when couples test together, particularly if their HIV sero-status is shown to be discordant. Further studies are required to explore how couples intend to use HIV testing services including CHTC. Disclosure No significant relationships.
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