title: User acceptability and feasibility of self-testing with HIV rapid tests.
abstract: OBJECTIVE
  Because HIV rapid tests are considered for self-testing, this study aims to determine the user acceptability and feasibility of self-testing.
  
  
  METHODS
  A cross-sectional study was performed on 350 systematically sampled participants across 2 Singapore HIV testing centers using the Abbott Determine HIV 1/2 blood sample rapid test (Abbott Laboratories, Abbott Park, IL). Participants were surveyed on knowledge of and attitudes toward rapid testing. To determine interrater agreement between self-testing and trained personnel testing, participants performed self-testing with visual instructions, followed by trained personnel testing. Ability to identify test outcomes was determined through interpretation of sample test results.
  
  
  RESULTS
  Eighty-nine percent of participants preferred testing in private, but most indicated that confidential counseling by trained counselors was necessary. Almost 90% found the kit easy to use and instructions easy to understand. Nevertheless, 85% failed to perform all steps correctly, especially blood sampling, and 56% had invalid results because of incorrect test performance. Interrater agreement between results from self-testing and trained personnel testing had a kappa value of 0.28. Twelve percent could not correctly determine results using sample tests, including 2% and 7% who read positive and negative samples, respectively, incorrectly.
  
  
  CONCLUSIONS
  A substantial proportion could not perform self-testing or identify outcomes. Self-testing with the Determine HIV 1/2 kit in Singapore should be deferred.
authors.affiliation: Department of Clinical Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, 802 Moulmein Road, Singapore. vernonljm@hotmail.com
authors.forename: Vernon J
authors.initials: VJ
authors.lastname: Lee
authors.forename: Soon Choon
authors.initials: SC
authors.lastname: Tan
authors.forename: Arul
authors.initials: A
authors.lastname: Earnest
authors.forename: Peck Suet
authors.initials: PS
authors.lastname: Seong
authors.forename: Hiok Hee
authors.initials: HH
authors.lastname: Tan
authors.forename: Yee Sin
authors.initials: YS
authors.lastname: Leo
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011933:Reagent Kits, Diagnostic; D012648:Self Care; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D011933:Reagent Kits, Diagnostic