Acceptability and performance of a directly assisted oral HIV self-testing intervention in adolescents in rural Mozambique

Whereas progress in HIV testing and treatment has been made globally, the UNAIDS goal of "90 90 90" is still out of sight in rural northern Mozambique. New strategies that promote testing in hard to reach groups will aid Mozambique's response to the HIV epidemic. HIV self-testing (HIV...

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Bibliographic Details
Published in:PloS one 2018-04, Vol.13 (4), p.e0195391-e0195391
Main Authors: Hector, Jonas, Davies, Mary-Ann, Dekker-Boersema, Johanna, Aly, Mussa Manuel, Abdalad, Cassimo Charifo A, Langa, Ernesto Belario Rafael, Ehmer, Jochen, Hobbins, Michael Andre, Jefferys, Laura Frances
Format: Article
Language:English
Subjects:
Acceptability
Acquired immune deficiency syndrome
Adolescents
AIDS
Biology and Life Sciences
Care and treatment
Epidemics
Health aspects
HIV
HIV tests
Human immunodeficiency virus
Intervention
Medicine and Health Sciences
People and Places
Schools
Security
Social Sciences
Students
Systematic review
Teenagers
Youth
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Summary:Whereas progress in HIV testing and treatment has been made globally, the UNAIDS goal of "90 90 90" is still out of sight in rural northern Mozambique. New strategies that promote testing in hard to reach groups will aid Mozambique's response to the HIV epidemic. HIV self-testing (HIVST) is recommended by the WHO as an additional approach to augment the HIV testing services available to adolescents. This study evaluates acceptability and performance of a directly assisted oral HIVST intervention for adolescents in rural Mozambique. Adolescents aged 16-20 years were included at schools and invited to attend the local hospital's youth friendly service for directly assisted oral HIVST. Baseline and post-test questionnaires were obtained. OraQuick Rapid HIV-1/2 Anti body test® was used. Results were read by the participant and by a nurse. Results were confirmed by finger prick HIV test (Determine® HIV 1/2 Alere and Unigold™ HIV Trinity Biotech) according to the Mozambican national standard. Between September and November 2016, 496 adolescents were included, of which 299 performed an oral HIV self-test. 70% were first time testers. The positivity rate was 1.7%. The inter-rater agreement between adolescent and nurse was 99.6% (kappa 0.93); there were no false negative or false positive results of the oral HIV self-test. Five tests were invalid. 7.1% found the test difficult to use. Over 80% preferred directly assisted HIVST compared to the standard finger prick testing. While 20% thought it would be good to do HIVST at home, 76% preferred to do HIVST at the health centre, for reasons including increased security, privacy, and the presence of a counsellor. Directly assisted oral HIVST is a feasible intervention for adolescents in rural Mozambique and showed encouraging results for first time HIV testers.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0195391