HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults
Zanolini,, A., Chipungu, J., Vinikoor, M.J., et al. AIDS Research and Human Retroviruses (e-publication ahead of print), doi:10.1089/AID.2017.0156.
The authors used a population-based survey of 1,617 adolescents and adults in Zambia to describe preferences for HIV self-testing (HIVST). They also conducted a discrete choice experiment (DCE) in which participants could choose among several testing models. Participants received HIVST instructions via either a visual aid sheet or video, and were tested on their comprehension. Following the video, 91 percent of respondents reported finding HIVST acceptable, and 87 percent reported that HIVST increased the likelihood of testing. Thirty-five percent expressed concerns about lack of counseling and suicide risk, but only 2.1 percent indicated that these concerns should reduce access to HIVST. Findings from the DCE demonstrated that counseling and HIVST motivated HIV testing. For those who had not been tested previously, having HIVST was the most important influence. Most participants who received the visual aid sheet (73%) expressed confidence about self-testing. Most participants who looked at the instructional video expressed confidence about using HIVST (79%), but the video did not increase knowledge on how to test. Participants were willing to pay US$3–5 for HIVST. The authors concluded that HIVST is highly acceptable and should be introduced via a pilot activity in Zambia; they urged further research to guide development of national guidance on HIVST.