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Is self-administered oral HIV testing a viable option in Africa?
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.”