Detection of new HIV infections in a multicentre HIV antiretroviral pre-exposure prophylaxis trial

Fransen, Katrien; Baetselier, Irith De; Rammutla, Elizabeth; Ahmed, Khatija; Owino, Frederick; Agingu, Walter; Venter, Gustav; Deese, Jennifer; Damme, Lut Van; Crucitti, Tania

doi:10.1016/j.jcv.2017.03.013

Cited by 3 publications

(2 citation statements)

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“…Taking PrEP with undetected HIV could lead to drug resistance, but a recent review of PrEP studies found that resistance selection for tenofovir disoproxil fumarate and emtricitabine with PrEP use is infrequent [28]. Evaluations of HIV rapid diagnostic tests (RDTs) among PrEP users have found variable sensitivities and specificities, with specificities >98% [29][30][31][32][33]. An evaluation of OraQuick ADVANCE â Rapid HIV-1/2, the kit we used in our study, found that it had high specificity (99.99%) and high negative predictive value (99.94%) [32].…”

Section: Discussionmentioning

confidence: 99%

“…Total visit time was shorter for those using HIVST compared to those who declined HIVST (median 33 vs. 54 minutes, p = 0.003) (Table 4), and total visit time during standard of care period was comparable to that of HIVST decliners (median 55 vs. 54 minutes). HIV testing itself was longer for HIVST than PITC (median [IQR]: 27 [26,30] vs. 15 [13, 17.5] minutes, p = 0.001) and PrEP dispensing time was slightly shorter for HIVST acceptors than decliners (median [IQR]: 2.5 [1,3] vs. 4 [3.3, 4], p = 0.01). Median waiting time was longer for HIVST decliners than HIVST acceptors (11 vs. 2 minutes), although this difference was not statistically significant.…”

Section: Hivst and Prep Delivery Processesmentioning

confidence: 99%

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Uptake and impact of facility‐based HIV self‐testing on PrEP delivery: a pilot study among young women in Kisumu, Kenya

et al. 2020

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Introduction HIV testing is a required part of delivery of pre‐exposure prophylaxis (PrEP) for HIV prevention. However, repeat testing can be challenging in busy, under‐staffed clinical settings, which could negatively impact PrEP uptake and continuation. We prospectively evaluated optional facility‐based HIV self‐testing (HIVST) among young women using PrEP in an implementation programme. Methods Between February and November 2019, we collected data from young women receiving PrEP at two family planning facilities in Kisumu, Kenya. At each PrEP follow‐up visit, women were given the option to choose between provider‐initiated testing and HIVST. We assessed factors associated with HIVST uptake and compared satisfaction with HIV testing and clinic experience between acceptors and decliners of HIVST. Results A total of 172 women were offered HIVST at 202 PrEP follow‐up visits. The median age was 21 years, 27% had multiple partners and 15% reported previously using HIVST. HIVST was accepted at 34.7% (70/202) of visits. Age (adjusted relative risk (aRR) 1.09 per year, 95% CI (confidence interval) 1.01 to 1.18), never being married (aRR 1.81, 95% CI 1.11 to 2.95) and having more PrEP follow‐up visits (aRR 1.13 per visit, 95% CI 1.04 to 1.23) were associated with HIVST uptake. Compared to HIVST decliners, HIVST acceptors were more likely to be very happy with their overall testing experience (73% vs. 47% of visits, p = 0.003) and were more likely to say they would use HIVST in the future (96% vs. 76%, p < 0.001). Women who accepted HIVST had shorter visits than those choosing standard provider‐initiated HIV testing (median [IQR]: 33 [32, 38] vs. 54 [41.5, 81] minutes, p = 0.003). Conclusions In this pilot evaluation in Kenya, about one‐third of women using PrEP opted for HIVST over provider‐initiated testing, and those choosing HIVST spent less time in the clinic and were generally satisfied with their experience. HIVST in PrEP delivery is feasible and has the potential to simplify PrEP delivery and give clients testing autonomy. Additional studies are needed to explore optimal HIV retesting strategies in PrEP delivery, including the use of HIVST in PrEP at a larger scale and in different settings.

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