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Dr. Elizabeth Kelvin, a professor at the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), and Dr. Matthew Romo, an epidemiology doctoral student at CUNY SPH, along with colleagues studied the predictors of choosing one HIV testing method over another within a sample of Kenyan truck drivers. The drivers were offered the choice of self-administered oral HIV testing in clinic with supervision, or the standard provider-administered blood test. The findings were published in the journal AIDS and Behavior.
Truck drivers in Africa have been characterized as a key population to target for HIV prevention, testing, and treatment services due to their high HIV risk and unmet need for services. The approval by the FDA of a rapid self-administered oral HIV test allowed this study to be conducted. The study explored potential predictors of choosing a self-administered oral rapid test over a standard blood test.
Male truck drivers from Kenya, who were over 18 years of age and were either HIV-negative or of unknown status were eligible for the study. Among those who were eligible, consenting participants were included in the randomized controlled trial and had a baseline questionnaire administered to them by a fieldworker. The baseline interview included questions about demographics, HIV testing, and risk behavior, as well as including questions aimed at determining five psychosocial measures: anticipated HIV stigma, general self-efficacy, including belief in one’s ability to cope with stressful and challenging demands, a measure of fatalism, gender-equity, and sensation-seeking.
Overall, 56.38 percent of participants chose the self-test, 23.49 percent the provider-administered test, and 20.13 percent refused testing. Overall, 52.38 percent of self-testers did so correctly without help from an individual in the room, 47.61 percent asked questions, and 13.10 percent required unsolicited correction from the provider. The higher a truck driver scored on the fatalism scale, the more likely they were to ask for guidance when self-testing.
Results of the study indicated that self-administered oral HIV testing was acceptable and feasible among Kenyan truck drivers, especially if given the opportunity to ask questions.
Dr. Romo explains, “Since HIV self-testing is currently being rolled out in Kenya, this study provides some useful insight about how to best implement self-testing in a ‘key’ population that is especially affected by the HIV epidemic. Specifically, having the opportunity to first use the self-testing kit supervised by a healthcare worker may be especially beneficial for truck drivers and possibly other populations.”
