Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: a randomized controlled trial

Abstract

We conducted a randomized controlled trial among 305 truck drivers from two North Star Alliance roadside wellness clinics in Kenya to see if offering HIV testing choices would increase HIV testing uptake. Participants were randomized to be offered (1) a provider-administered rapid blood (finger-prick) HIV test (i.e., standard of care [SOC]) or (2) a Choice between SOC or a self-administered oral rapid HIV test with provider supervision in the clinic. Participants in the Choice arm who refused HIV testing in the clinic were offered a test kit for home use with phone-based posttest counseling. We compared HIV test uptake using the Mantel Haenszel odds ratio (OR) adjusting for clinic. Those in the Choice arm had higher odds of HIV test uptake than those in the SOC arm (OR = 1.5), but the difference was not statistically significant (p = 0.189). When adding the option to take an HIV test kit for home use, the Choice arm had significantly greater odds of testing uptake (OR = 2.8, p = 0.002). Of those in the Choice arm who tested, 26.9% selected the SOC test, 64.6% chose supervised self-testing in the clinic, and 8.5% took a test kit for home use. Participants varied in the HIV test they selected when given choices. Importantly, when participants who refused HIV testing in the clinic were offered a test kit for home use, an additional 8.5% tested. Offering truck drivers a variety of HIV testing choices may increase HIV testing uptake in this key population.

HIV testing preferences among pregnant women attending antenatal care and their male partners: a discrete choice experiment in Uganda

“…These results stand in contrast to the results of DCE work in Kenya, which found no preference between oral or finger prick tests among individuals who had tested before, but a clear preference for the oral test among those who had never tested (Strauss, George, Lansdell, et al, 2018). Furthermore, in previous DCE work in Kenya, situated in a randomised trial in which participants were offered supervised oral self-testing or nurse-administered blood-based testing (Kelvin et al, 2018a(Kelvin et al, , 2018b, we found that participants opting to self-test indicated a preference for an oral test in the DCE, while participants opting for nurse-administered testing indicated a preference for a blood-based test . The oral test currently has a higher cost than the rapid blood-based test, both on the commercial market and in subsidised settings.…”

A Randomized Controlled Trial to Increase HIV Testing Demand Among Female Sex Workers in Kenya Through Announcing the Availability of HIV Self-testing Via Text Message

“…The impact of HIV self-testing on testing rates has ranged from a RR of 1.1–2.1, depending on the study design and population [4–9]. Thus, the impact of offering HIV self-testing seems to be fairly consistent across population groups, distribution methods (e.g., bringing the test kits to people or allowing people to access test kits from a clinic), and geographic region within sub-Saharan Africa.…”

Stakeholders’ recommendations for implementing HIV self-testing and secondary distribution of HIV self-testing for male partners of Option B+ clients in Haiti as an assisted partner service strategy: a qualitative study

“…Specifically, stakeholders recommended campaigns to raise awareness and educate people about HIVST, piloting of different strategies, and engaging the CHWs in conjunction with the formal health sector. Different HIVST campaign strategies and distribution models for HIVST, including self-testing with supervision from formal health sector workers (43), have been piloted and evaluated successfully in randomized controlled trials conducted in other countries (17,44). Volunteer residents, community HIV care providers, women, and peer educators have been engaged to promote HIVST by distributing flyers and HIVST kits to community residents, male partners, and peers (17,26,42,(45)(46)(47)(48).…”