Adolescents’ experience of a rapid HIV self‐testing device in youth‐friendly clinic settings in Cape Town South Africa: a cross‐sectional community based usability study

Abstract

Introduction: Since HIV testing in South African adolescents and young adults is sub-optimal, the objective of the current study was to investigate the feasibility and acceptability of an HIV rapid self-testing device in adolescents and young people at the Desmond Tutu HIV Foundation Youth Centre and Mobile Clinic. Methods: Self-presenting adolescents and young adults were invited to participate in a study investigating the fidelity, usability and acceptability of the AtomoRapid HIV Rapid self-testing device. Trained healthcare workers trained participants to use the device before the participant conducted the HIV self-test with device usage instructions. The healthcare worker then conducted a questionnaire-based survey to assess outcomes. Results: Of the 224 enrolled participants between 16 and 24 years of age, 155 (69,2%) were female. Overall, fidelity was high; 216 (96,4%) participants correctly completed the test and correctly read and interpreted the HIV test result. There were eight (3,6%) user errors overall; six participants failed to prick their finger even though the lancet fired correctly. There were two user errors where participants failed to use the capillary tube correctly. Participants rated acceptability and usability highly, with debut testers giving significantly higher ratings for both. Younger participants gave significantly higher ratings of acceptability. Conclusions: Adolescents and young adults found HIV self-testing highly acceptable with the AtomoRapid and they used the device accurately. Further research should investigate how, where and when to deploy HIV self-testing as a means to accompany existing strategies in reaching the UNAIDS goal to test 90% of all individuals worldwide.

Barriers to, and emerging strategies for, HIV testing among adolescents in sub-Saharan Africa

“…A study conducted among 16-24 years olds in South Africa to evaluate self-testing using a rapid blood test demonstrated that 96.4% completed the test correctly and were able to interpret the test results (48), and only 3% of participants failed to prick their finger (48). In recent years, HIV self-testing using oral mucosal transudate (OMT) HIV tests has been shown to be highly acceptable and accurately performed by adults in SSA (37,49).…”

Ability to understand and correctly follow HIV self‐test kit instructions for use: applying the cognitive interview technique in Malawi and Zambia

“…Video evaluation showed multiple errors in specimen collection, use of buffer, read times and interpretation of results, regardless of whether the kit was oral fluid based or blood based [16]. Errors persisted even after self-test prototypes were further adapted [9,10,12,14,17]. Blood-based self-tests have been shown to be more sensitive than oral fluid-based tests, but evidence suggests that invalid results among self-testers may be also be higher [18][19][20][21].…”

Preferences for HIV testing services among young people in Nigeria

“…Young people's preferences for blood based HIVST was surprising given the high preference for facility-based HIV testing. This discordance in preference for HIV testing could be because of limited [16,23], Asia [24] and Europe [25]. Our findings also suggest that in addition to increasing knowledge of and awareness of HIV prevention, efforts should be made to integrate information on the full range of testing approaches and prevention tools currently available within Nigeria [2].…”