title: Use of tablet-based kiosks in the emergency department to guide patient HIV self-testing with a point-of-care oral fluid test.
abstract: Despite successes in efforts to integrate HIV testing into routine care in emergency departments, challenges remain. Kiosk-facilitated, directed HIV self-testing offers one novel approach to address logistical challenges. Emergency department patients, 18-64 years, were recruited to evaluate use of tablet-based-kiosks to guide patients to conduct their own point-of-care HIV tests followed by standard-of-care HIV tests by healthcare workers. Both tests were OraQuick Advance tests. Of 955 patients approached, 473 (49.5%) consented; 467 completed the test, and 100% had concordant results with healthcare workers. Median age was 41 years, 59.6% were female, 74.8% were African-American, and 19.6% were White. In all, 99.8% of patients believed the self-test was "definitely" or "probably" correct; 91.7% of patients "trusted their results very much"; 99.8% reported "overall" self-testing was "easy or somewhat easy" to perform. Further, 96.9% indicated they would "probably" or "definitely" test themselves at home were the HIV test available for purchase; 25.9% preferred self-testing versus 34.4% who preferred healthcare professional testing (p>0.05). Tablet-based kiosk testing proved to be highly feasible, acceptable, and an accurate method of conducting rapid HIV self-testing in this study; however, rates of engagement were moderate. More research will be required to ascertain barriers to increased engagement for self-testing.
authors: Div Infectious Disease, Johns Hopkins University, Baltimore, MD, USA.
authors: Charlotte A
authors: CA
authors: Gaydos
authors: Melissa
authors: M
authors: Solis
authors: Yu-Hsiang
authors: YH
authors: Hsieh
authors: Mary
authors: M
authors: Jett-Goheen
authors: Samah
authors: S
authors: Nour
authors: Richard E
authors: RE
authors: Rothman
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000293:Adolescent; D000328:Adult; D059026:Diagnostic Self Evaluation; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005240:Feasibility Studies; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D006679:HIV Seropositivity / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D019095:Point-of-Care Systems; D012463:Saliva; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: AIDS; HIV; Human immunodeficiency virus; OraQuick Advance; acceptability; emergency department; oral fluid; point of care test; rapid test; screening; self-testing; tablet-based-kiosks; testing
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