• Blood-based human immunodeficiency virus self-testing
• Human immunodeficiency virus self-testing
• Oral human immunodeficiency virus self-testing
• Preferences

• HIV
• HIV self-testing (HIVST)
• HIV testing
• HIV/AIDS (acquired immunodeficiency syndrome)
• Kenya
• implementation science
• truck driver

• hiv
• children
• pediatric hiv testing
• saliva-based testing

• Caregivers
• Child
• HIV Infections/diagnosis
• Health Personnel
• Humans
• Patient Acceptance of Health Care
• Saliva

• D43 TW009783 FIC NIH HHS
• K43 TW011422 FIC NIH HHS
• P30 AI027757 NIAID NIH HHS

• HIV self-testing
• Kenya
• community-based research
• men who have sex with men
• science and technology studies
• sex work

• Discrete choice experiment
• HIV testing
• I
• I1
• I12
• I18
• P
• P4
• P46
• South Africa
• people living with HIV/AIDs
• preferences for HIV testing
• stated preferences

• Adult
• Choice Behavior
• Female
• HIV Infections/diagnosis
• HIV Infections/drug therapy
• HIV Testing
• Humans
• Patient Preference
• South Africa

• Engagement
• Health services
• Men
• Scoping review

Ending AIDS by 2030 is a global target, to which India is a signatory. HIV-self-test (HIVST) coupled with counselling and AIDS-care, including antiretroviral therapy, has the potential to achieve this. However, national programs are at varying stages of acceptance of HIVST, as discussions around its introduction spark controversy and debates. HIV-self-test, as yet, is not part of the AIDS control program in India. Against this backdrop, we explored acceptability of an HIV oral self-test (HIVOST) among truckers and young men and women.

A qualitative investigation with 41 in-depth-interviews and 15 group discussions were conducted in the district of Pune, in the western state of Maharashtra, India. These interactions were built around a prototype HIVOST kit, helped in taking the discussions forward. The software N-vivo (version 11.0) was used to manage the volumes of data generated through the aforementioned process. The study was conducted during June through December, 2019.

While the truckers belonged to the age bracket 21–67 year, the youths were in the age group 18–24 year. ‘Ease of doing HIVOST’ and ‘fear of needle pricks’ were the reasons behind acceptance around HIVOST by both the study groups. Truckers felt that HIVOST would encourage one to know one’s HIV status and seek help as appropriate. Accuracy of HIVOST result and disposal of the kits following use were concerns of a few. Most of the participants preferred saliva over blood as the specimen of choice. Instructions in local language reportedly would enable test-use by self. The truck drivers preferred undertaking HIVOST at the truckers-friendly ‘Khushi clinics’ or in the vehicle, while youths preferred the privacy of home. Some of the young men mis-perceived the utility of HIVOST by referring to doing a test on a partner immediately prior to sexual encounter. On the other hand, a few truckers had wrong information on HIV cure.

Overall, the study communities expressed their acceptance towards HIV-self-test. The National AIDS Control Program, India would benefit by drawing upon the findings of the current investigation. Existing myths and misconceptions around HIV test and treatment require program attention.

The online version contains supplementary material available at 10.1186/s12889-021-11963-7.

• Community voices
• HIV self-test
• Truckers
• Youths

• HIV
• Service integration
• Substance use
• Substance use treatment
• Testing

• HIV and AIDS
• PrEP
• adolescent girls and young women
• adolescent health
• health policy
• pre-exposure prophylaxis
• prevention

• Developing Countries/statistics & numerical data
• HIV Infections/diagnosis
• Humans
• Implementation Science
• Reagent Kits, Diagnostic/economics
• Reagent Kits, Diagnostic/standards
• Reagent Kits, Diagnostic/statistics & numerical data
• Self-Testing

• Northwestern University Open Access Fund

• HIV
• HIV self-testing
• Implementation science

• Kenya
• self-administered HIV testing
• social-ecological model
• truck drivers

• Female sex workers, acceptability, exploratory study
• HIV self-testing
• Tanzania

• Adult
• Counseling/statistics & numerical data
• Female
• HIV Infections/prevention & control
• HIV Infections/psychology
• Humans
• Male
• Mass Screening/psychology
• Patient Acceptance of Health Care/psychology
• Self-Examination/psychology
• Self-Examination/statistics & numerical data
• Serologic Tests/psychology
• Serologic Tests/statistics & numerical data
• Sex Work/psychology
• Sex Work/statistics & numerical data
• Sex Workers/psychology
• Sex Workers/statistics & numerical data
• Social Stigma
• Tanzania
• Trust

• AID-621-A-15-00003 U.S. President's Emergency Plan for AIDS Relief (US)
• U.S. President’s Emergency Plan for AIDS Relief (US)

Door-to-door distribution of HIV self-testing kits (HIVST) has the potential to increase uptake of HIV testing services (HTS). However, very few studies have explored the social response to and implications of door-to-door including secondary distribution of HIVST on household relations and the ability of individuals to self-test with or without supervision within households.

A CRT of HIVST distribution was nested within the HPTN 071 (PopART) trial, in four Zambian communities randomised to receive the PopART intervention. The nested HIVST trial aimed to increase knowledge of HIV status at population level. Between February 1 and April 30, 2017, 66 zones (clusters) within these four communities were randomly allocated to either the PopART standard of care door-to-door HTS (33 clusters) or PopART standard of care door-to-door HTS plus oral HIVST (33 clusters). In clusters randomised to HIVST, trained Community HIV care provider (CHiPs) visited households and offered individuals aged ≥ 16 and eligible for an offer of HTS the choice of HIV testing using HIVST or routine door-to-door HTS (finger-prick RDT). To document participants’ experiences with HIVST, Interviews (n = 40), observations (n = 22) and group discussions (n = 91) with household members and CHiPs were conducted. Data were coded using Atlas.ti 7 and analysed thematically.

The usage and storage of HIVST kits was facilitated by familiarity with and trust in CHiPs, the novelty of HIVST, and demonstrations and supervision provided by CHiPs. Door-to-door distribution of HIVST kits was appreciated for being novel, convenient, private, empowering, autonomous and easy-to-use. Literacy and age influenced accurate usage of HIVST kits. The novelty of using oral fluids to test for HIV raised questions, some anxiety and doubts about the accuracy of HIVST. Although HIVST protected participants from experiencing clinic-based stigma, it did not address self-stigma. Within households, HIVST usually strengthened relationships but, amongst couples, there were a few reports of social harms.

Door-to-door distribution of HIVST as a choice for how to HIV test is appreciated at community level and provides an important testing option in the sub-Saharan context. However, it should be accompanied by counselling to manage social harms and by supporting those testing HIV-positive to link to care.

• Community health workers
• Door -to-door distribution of HIVST
• HIV self-testing
• Social harms
• Zambia

• Africa
• HIV
• HIV self-testing
• adolescents
• children
• oral mucosal transudate tests

• HIV self-testing
• HIV testing
• HIVST
• Males
• Men
• Sub-Saharan Africa

• East Africa
• couples testing
• randomized controlled trial

• Adult
• Ambulatory Care Facilities
• Female
• HIV Infections/diagnosis
• HIV Infections/epidemiology
• HIV Infections/psychology
• Humans
• Male
• Mass Screening/psychology
• Patient Preference/statistics & numerical data
• Pregnancy
• Pregnant Women/psychology
• Prenatal Care/psychology
• Prenatal Care/statistics & numerical data
• Sexual Partners/psychology
• Uganda/epidemiology

• R25 GM072643 NIGMS NIH HHS
• R25 GM113278 NIGMS NIH HHS
• TL1 TR001451 NCATS NIH HHS
• UL1 TR001450 NCATS NIH HHS

• Experiential learning
• HIV
• Nurse education
• Self-test
• Student experience
• Student nurses

• Adult
• Education, Nursing, Baccalaureate/methods
• Female
• HIV Infections/diagnosis
• Humans
• Interviews as Topic
• Mass Screening/methods
• Problem-Based Learning
• Qualitative Research
• Reagent Kits, Diagnostic
• Self Care/psychology
• Students, Nursing/psychology
• Taiwan

• 90–90-90
• Complementarity of HIVST
• HCT
• HIV self-testing
• HIV testing
• Unsupervised HIVST

• Adult
• Counseling
• Cross-Over Studies
• Female
• HIV
• HIV Infections/diagnosis
• HIV Infections/virology
• Humans
• Male
• Rural Population
• Self Care
• South Africa
• Urban Population

• AtomoRapid
• HIV self-test
• alternative blood-based test
• most at risk populations
• young people

• HIV self-testing
• HIV testing
• IMB model
• expedited partner therapy
• patient-delivered partner therapy
• sexually transmitted infections

• R01 DA036466 NIDA NIH HHS
• R01 MH089129 NIMH NIH HHS

• Discrete choice experiment
• HIV
• HIV testing
• Kenya
• Truck drivers

• Adult
• Automobile Driving
• Choice Behavior
• HIV Infections/diagnosis
• Humans
• Kenya
• Male
• Mass Screening/methods
• Mass Screening/statistics & numerical data
• Motor Vehicles
• Mouth/virology
• Self Care/psychology

• P30 AI124414 NIAID NIH HHS
• P30 MH043520 NIMH NIH HHS
• International initiative for impact evaluation
• National Institute of Mental Health (NIMH) to the HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University

• HIV
• MSM
• HIV positivity rate
• Nigeria
• feasibility
• linkage to treatment
• self-testing

• Adolescent
• Adult
• Cohort Studies
• HIV Infections/diagnosis
• HIV Infections/epidemiology
• HIV Infections/therapy
• Homosexuality, Male/statistics & numerical data
• Humans
• Male
• Middle Aged
• Nigeria/epidemiology
• Pilot Projects
• Reagent Kits, Diagnostic
• Self Care
• Sexual and Gender Minorities
• Social Stigma
• Young Adult

• R21 AI124409 NIAID NIH HHS

• Adolescent
• Adult
• Female
• HIV Infections/diagnosis
• Humans
• Male
• Mass Screening/methods
• Mozambique
• Reagent Kits, Diagnostic
• Rural Population
• Self Care/methods
• Surveys and Questionnaires
• Young Adult

We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0.97 (p = 0.003) and 0.83 (p = 0.008) times lower odds of choosing the self-test, respectively. Overall, 52.38% of self-testers did so correctly without questions, 47.61% asked questions, and 13.10% required unsolicited correction from the provider. Each additional unit on the fatalism scale was associated with 1.07 times higher odds of asking for guidance when self-testing (p < 0.001). Self-administered oral HIV testing seems to be acceptable and feasible among Kenyan truck drivers, especially if given the opportunity to ask questions.

• Diagnostic tests
• HIV
• HIV testing
• Kenya

• hiv self-testing
• hiv testing
• sub-saharan africa

• Africa South of the Sahara
• Diagnostic Tests, Routine/methods
• Diagnostic Tests, Routine/statistics & numerical data
• HIV Infections/diagnosis
• Health Policy
• Humans
• Procedures and Techniques Utilization
• Self Administration/methods
• Self Administration/statistics & numerical data

• 200901/Z/16/Z Wellcome Trust
• WT091769 Wellcome Trust
• WT105828 Wellcome Trust

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.

• Diagnostic tests
• HIV
• HIV testing
• Kenya