title: Accuracy and Acceptability of Oral Fluid HIV Self-Testing in a General Adult Population in Kenya.
abstract: We evaluated performance, accuracy, and acceptability parameters of unsupervised oral fluid (OF) HIV self-testing (HIVST) in a general population in western Kenya. In a prospective validation design, we enrolled 240 adults to perform rapid OF HIVST and compared results to staff administered OF and rapid fingerstick tests. All reactive, discrepant, and a proportion of negative results were confirmed with lab ELISA. Twenty participants were video-recorded conducting self-testing. All participants completed a staff administered survey before and after HIVST to assess attitudes towards OF HIVST acceptability. HIV prevalence was 14.6 %. Thirty-six of the 239 HIVSTs were invalid (15.1 %; 95 % CI 11.1-20.1 %), with males twice as likely to have invalid results as females. HIVST sensitivity was 89.7 % (95 % CI 73-98 %) and specificity was 98 % (95 % CI 89-99 %). Although sensitivity was somewhat lower than expected, there is clear interest in, and high acceptability (94 %) of OF HIV self-testing.
authors.affiliation: New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10003, USA. akurth@nyu.edu.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Kurth
authors.affiliation: New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10003, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
authors.affiliation: New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10003, USA.
authors.forename: Nok
authors.initials: N
authors.lastname: Chhun
authors.affiliation: Department of General Internal Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Sidle
authors.affiliation: Department of Reproductive Health, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.|Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Edwin
authors.initials: E
authors.lastname: Were
authors.affiliation: Department of Behavioral Sciences, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.|Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Violet
authors.initials: V
authors.lastname: Naanyu
authors.affiliation: Department of Immunology, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.|Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Wilfred
authors.initials: W
authors.lastname: Emonyi
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.|Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Macharia
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Edwin
authors.initials: E
authors.lastname: Sang
authors.affiliation: Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.|Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Abraham M
authors.initials: AM
authors.lastname: Siika
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods* / Q000706:statistics & numerical data; D000328:Adult; D005260:Female; D015483:HIV Antibodies / Q000097:blood* / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006679:HIV Seropositivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya; D008297:Male; D008403:Mass Screening; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic / Q000706:statistics & numerical data; D012648:Self Care; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D015483:HIV Antibodies; D011933:Reagent Kits, Diagnostic
keywords: HIV; Oral fluid; Self-testing; Sensitivity; Specificity