Comparison of practicability and effectiveness between unassisted HIV selftesting and directly assisted HIV self-testing in the Democratic Republic of the Congo: a randomized feasibility trial
HIV; HIV self-testing; Unassisted HIV self-testing; Directly assisted HIV self-testing; Democratic Republic of the Congo
Abstract :
[en] Background: HIV self-testing (HIVST) can be performed using directly assisted and unassisted approaches in facilities or communities to reach different populations. The aim of this study was to compare the practicability andeffectiveness of the two delivery approaches for HIVST, unassisted HIVST (UH) and directly assisted HIVST (DAH), in the field setting of Kisangani, the Democratic Republic of the Congo (DRC).
Methods: A randomized (1:1), non-blinded, non-inferiority trial using a blood-based and facility-based HIVST method was carried out in four facilities in Kisangani, the DRC, targeting populations at high risk for HIV infection. The primary outcome was the difference in the practicability of the HIV self-test between the two arms. Practicability was defined as successfully performing the test and correctly interpreting the result. Requests for assistance, positivity rate, linkage to care, and willingness to buy an HIV self-test kit constituted the secondary outcomes for HIVST effectiveness. The adjusted risk ratios (aRRs) were calculated using Poisson regression.
Results: The rate of successfully performing the test was same (93.2%) in the UH and DAH arms. The rate of correctly interpreting the results was 86.9% in the UH arm versus 93.2% in the DAH arm, for a difference of − 6.3%. After the follow-up 72 h later, participants in the UH arm had a significantly lower chance of correctly interpreting the test results than those in the DAH arm (aRR: 0.60; P = 0.019). Although the positivity rate was 3.4% among the participants in the DAH arm and 1.7% among those in the UH arm, no significant differences were found between the two arms in the positivity rate, requests for assistance, and linkage to care. Willingness to buy an HIV self-test was higher in the UH arm than in the DAH arm (92.3% versus 74.1%; aRR: 4.20; P < 0.001).Conclusion: The results of this study indicate that UH is as practicable and effective as DAH among individuals at high risk for HIV infection in Kisangani, the DRC. However, additional support tools need to be assessed to improve the interpretation of the self-test results when using the UH approach.
Research center :
UNIKIS - University of Kisangani
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
Tonen-Wolyec, Serge; Ecole Doctorale Régionale D’Afrique Centrale en Infectiologie Tropicale, Franceville, Gabon ; University of Bunia, Bunia, Democratic Republic of the Congo ; University of Kisangani, Kisangani, Democratic Republic of the Congo
Kayembe Tshilumba, Charles; University of Kisangani, Kisangani, Democratic Republic of the Congo > Internal Medicine
Batina-Agasa, Salomon; University of Kisangani, Kisangani, Democratic Republic of the Congo > Internal Medicine
Hayette, Marie-Pierre ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Bact., mycologie, parasitologie, virologie, microbio.
Belec, Laurent; Hôpital Européen Georges Pompidou, and University of Paris Descartes, Paris Sorbonne Cité, Paris, France > Laboratory of virology
Language :
English
Title :
Comparison of practicability and effectiveness between unassisted HIV selftesting and directly assisted HIV self-testing in the Democratic Republic of the Congo: a randomized feasibility trial
Alternative titles :
[fr] Comparaison de la faisabilité et de l'efficacité entre l'autotest du VIH non assisté et l'autotest du VIH assisté en RDC: un essai de faisabilité randomisé
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