Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis

Jamil, Muhammad S; Eshun‐Wilson, Ingrid; Witzel, T. Charles; Siegfried, Nandi; Figueroa, Carmen; Chitembo, Lastone; Msimanga-Radebe, Busisiwe; Pasha, Muhammad Safdar Kamal; Hatzold, Karin; Corbett, Elizabeth L.; Barr-DiChiara, Magdalena; Rodger, Alison; Weatherburn, Peter; Geng, Elvin; Baggaley, Rachel; Johnson, Cheryl

doi:10.1016/j.eclinm.2021.100991

Cited by 54 publications

(67 citation statements)

References 30 publications

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“…UTT interventions are intensive testing programmes designed to find even the hardest-to-reach populations. Systematic review and meta-analysis of linkage to treatment or care following HIVST in the general population has found limited but encouraging evidence of successful linkage among HIVST users [ 31 ]. Further research is needed to assess cost-effective and sustainable interventions designed to strengthen linkage to treatment and care following HIVST, such as assisted referrals and home ART initiation.…”

Section: Discussionmentioning

confidence: 99%

Acceptability of unsupervised peer-based distribution of HIV oral self-testing for the hard-to-reach in rural KwaZulu Natal, South Africa: Results from a demonstration study

et al. 2022

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Background Innovative models to distribute oral HIV self-tests (HIVST) provide an opportunity to increase access to HIV testing, especially for hard-to-reach populations. This study aimed to describe the acceptability of unsupervised peer-distribution of HIVST as a method to scale-up HIV testing. Methods In this study, lay counsellors or community health workers provided HIVST kits to primary recipients (PRs) for distribution to their sexual partners, anyone in their social network (termed secondary recipients) or for self-testing, from September 2018 to March 2020. The study was conducted in Eshowe and Mbongolwane areas in KwaZulu-Natal, South Africa. A structured questionnaire was administered during the recruitment and passive follow-up, when people came for confirmatory HIV testing. Electronic records were retrospectively examined to determine initiation of antiretroviral treatment (ART) for all HIVST users and non-users. Results Among 36,708 people approached to be primary recipients, 9,891 (26.9%) accepted; 31,341 HIVST kits were distributed with a median of three (IQR: 2–4) per peer. PRs were predominately recruited at primary health clinics (PHCs). However, acceptability of HIVST was thrice as high at community-based testing sites compared to PHCs (64.5% vs. 21.0%; p<0.001). During the study period, 34,715 adults were tested for HIV at both PHCs and community-based testing sites; of these, 1,089 individuals reported HIVST use. Among HIVST users, 893 (82.0%) returned to the clinic for confirmatory testing after testing negative on HIVST; 196 (17.9%) were confirmed HIV positive following a positive HIVST. After excluding 36/196 (18.4%) participants for whom clinical records could not be found in electronic register and 25/160 (15.6%) who were already on ART before receiving HIVST, 129/135 (95.5%) initiated ART, whereas 2,362/2685 (88%) of HIV positive HIVST non-users-initiated ART. Conclusion Unsupervised peer-distribution of HIVST was feasible and acceptable, with more than 25% accepting to be peer-distributors. Acceptability of HIVST was thrice as high in community sites compared to clinics.

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Section: Discussionmentioning

confidence: 99%

Acceptability of unsupervised peer-based distribution of HIV oral self-testing for the hard-to-reach in rural KwaZulu Natal, South Africa: Results from a demonstration study

et al. 2022

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“…There are concerns that people self‐testing for infectious diseases may not behave in the optimal manner to maximise public health benefits of the self‐test upon receiving their result. These concerns have been assessed in HIV and hepatitis C self‐testing acceptability studies [ 22 , 23 ]. In the present survey, the majority of respondents expressed that, if they self‐tested positive for SARS‐CoV‐2, they would continue adhering to health authorities recommendations such as wearing masks and/or reporting the result.…”

Section: Discussionmentioning

confidence: 99%

Values and preferences of the general population in Indonesia in relation to rapid COVID‐19 antigen self‐tests: A cross‐sectional survey

Thomas

Shilton

Thomas

et al. 2022

Tropical Med Int Health

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Objectives Home diagnostics are essential to assist members of the general population become active agents of case detection. In Indonesia, a country with an over‐burdened healthcare system, individuals could use rapid SARS‐CoV‐2 antigen tests to self‐detect COVID‐19. To assess the general population's values and attitudes towards SARS‐CoV‐2 self‐testing, a survey was conducted in mid‐2021 in Jakarta and the provinces of Banten and North Sulawesi. Methods This was a quantitative survey that approached respondents in >600 randomly selected street‐points in the three study geographies in July–August 2021. A 35‐item questionnaire was used to collect data on key variables, such as likelihood to use a SARS‐CoV‐2 self‐test, willingness to pay for a self‐test device, and likely actions following a positive self‐test result. Bivariate and multivariate regression analyses were performed. Results Of 630 respondents (318 were female), 15.53% knew about COVID‐19 self‐testing, while 62.70% agreed with the idea of people being able to self‐test at home, unassisted, for COVID‐19. If self‐tests were available in Indonesia, >60% of respondents would use them if they felt it necessary and would undertake regular self‐testing for example weekly if recommended. Upon receiving a positive self‐test result, most respondents would communicate it (86.03%), request post‐test counselling (80.79%), self‐isolate (97.46%), and/or warn their close contacts (90.48%). Conclusions The use of rapid SARS‐CoV‐2 antigen detection tests for self‐testing appears acceptable to a majority of the Indonesian public, to learn whether they have COVID‐19. Self‐testing should be prioritised to complement to an over‐burdened healthcare system by helping the public, asymptomatic individuals included, become agents of change in epidemiological surveillance of SARS‐CoV‐2 in their communities.

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“…in the Netherlands 11 ). In a systematic review of HIV self-testing in which most identified studies were from sub-Saharan Africa, there were similar numbers of participants linked to HIV care/treatment among those diagnosed through self-testing and those diagnosed by standard testing suggesting that self-testing has the potential to lead to similar levels of management of chronic conditions 31 ; however, further research is needed to explore this in detail for other chronic conditions in areas of low health literacy. Finally, while the researchers received training in the use of the self-assessment kits and measurements, including in the application of World Health Organization protocols for anthropometry 13 and International Society of Hypertension protocols for blood pressure measurement 14 , it is possible that they made errors in their measurements.…”

Section: Discussionmentioning

confidence: 99%

Reliability, usability and identified need for home-based cardiometabolic health self-assessment during the COVID-19 pandemic in Soweto, South Africa

Calvert

Kolkenbeck‐Ruh

Crouch

et al. 2022

Sci Rep

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A major obstacle to tackling the growing burden of chronic disease in South Africa is lack of testing, particularly where individuals face multiple barriers to accessing health services. We conducted a pilot study to evaluate a cardiometabolic self-measurement kit, including assessment of blood pressure, obesity and urine analysis, amongst adults in Soweto, South Africa. Participants (N = 94) were recruited by researchers during community health screening and were provided with a home test kit including a tablet with self-measurement instructions. The participants entered their results on the tablet and, on completion, the researcher immediately repeated the measurements. We interviewed 10% of participants to understand their experience and views of the kits. Concordance correlation coefficients ranged from 0.78 for waist circumference to 0.93 for height, while the overall percentage agreement ranged from 80.5% for both urine protein and urine glucose testing to 91.4% for the identification of central obesity (ratio of waist circumference to height of ≥ 0.5). Participants saw the need for self-testing and found the process for the most part simple, though urine testing and height self-assessment presented some challenges. This pilot study suggests that self-assessment at home has the potential to facilitate the identification of individuals at risk for cardiometabolic disease in low-income settings, adding to a growing body of evidence on the use of self-testing in disease prevention and detection. However, we would not recommend self-testing for urine glucose and protein without further study.

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Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: A systematic review and meta-analysis

Cited by 54 publications

References 30 publications

Acceptability of unsupervised peer-based distribution of HIV oral self-testing for the hard-to-reach in rural KwaZulu Natal, South Africa: Results from a demonstration study

Acceptability of unsupervised peer-based distribution of HIV oral self-testing for the hard-to-reach in rural KwaZulu Natal, South Africa: Results from a demonstration study

Values and preferences of the general population in Indonesia in relation to rapid COVID‐19 antigen self‐tests: A cross‐sectional survey

Reliability, usability and identified need for home-based cardiometabolic health self-assessment during the COVID-19 pandemic in Soweto, South Africa

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