title: Will an unsupervised self-testing strategy be feasible to operationalize in Canada? Results from a pilot study in students of a large canadian university.
abstract: Background. A convenient, private, and accessible HIV self-testing strategy stands to complement facility-based conventional testing. Over-the-counter oral HIV self-tests are approved and available in the United States, but not yet in Canada. Canadian data on self-testing is nonexistent. We investigated the feasibility of offering an unsupervised self-testing strategy to Canadian students. Methods. Between September 2011 and May 2012, we recruited 145 students from a student health clinic of a large Canadian university. Feasibility of operationalization (i.e., self-test conduct, acceptability, convenience, and willingness to pay) was evaluated. Self-test conduct was computed with agreement between the self-test performed by the student and the test repeated by a healthcare professional. Other metrics were measured on a survey. Results. Participants were young (median age: 22 years), unmarried (97%), and 47% were out of province or international students. Approximately 52% self-reported a history of unprotected casual sex and sex with multiple partners. Self-test conduct agreement was high (100%), so were acceptability (81%), convenience (99%), and willingness to pay (74%) for self-tests. Concerns included accuracy of self-tests and availability of expedited linkages. Conclusion. An unsupervised self-testing strategy was found to be feasible in Canadian students. Findings call for studies in at-risk populations to inform Canadian policy.
authors: Department of Medicine, McGill University, Montreal, QC, Canada H3A 1A1 ; Division of Clinical Epidemiology, McGill University and Health Centre, Montreal, QC, Canada H3A 1A1.
authors: Nitika
authors: N
authors: Pant Pai
authors: Division of Clinical Epidemiology, McGill University and Health Centre, Montreal, QC, Canada H3A 1A1.
authors: Madhavi
authors: M
authors: Bhargava
authors: Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, QC, Canada H3A 1A2.
authors: Lawrence
authors: L
authors: Joseph
authors: Department of Medicine, McGill University, Montreal, QC, Canada H3A 1A1.
authors: Jigyasa
authors: J
authors: Sharma
authors: Division of Clinical Epidemiology, McGill University and Health Centre, Montreal, QC, Canada H3A 1A1.
authors: Sabrina
authors: S
authors: Pillay
authors: Department of Medicine, McGill University, Montreal, QC, Canada H3A 1A1.
authors: Bhairavi
authors: B
authors: Balram
authors: McGill University Student Health Services, Montreal, QC, Canada H3A 0G3.
authors: Pierre-Paul
authors: PP
authors: Tellier