title: Feasibility and acceptability of HIV self-testing among pre-exposure prophylaxis users in Kenya.
abstract: HIV testing is key to the delivery of pre-exposure prophylaxis (PrEP): testing HIV-uninfected at-risk persons is the first step for PrEP initiation and ongoing HIV testing is an essential part of PrEP delivery. Thus, novel and cost-effective HIV-testing approaches to streamline delivery of PrEP are urgently needed. Within a demonstration project of PrEP for HIV prevention among high-risk HIV serodiscordant couples in Kenya (the Partners Demonstration Project), we conducted a pilot evaluation of HIV self-testing.
  
  
  
  Clinic visits were scheduled quarterly and included in-clinic HIV testing using fingerstick rapid HIV tests and refills of PrEP prescriptions. HIV oral fluid self-test kits were provided for participants to use in the two-month interval between scheduled quarterly clinic visits. Acceptability of HIV self-testing was assessed using both quantitative and qualitative methods.
  
  
  
  We found that 222 of 226 (98%) HIV-uninfected persons who were offered accepted self-testing. Nearly all (96.8%) reported that using the self-testing kit was easy. More than half (54.5%) reportedly did not share the HIV results from self-testing with anyone and almost all (98.7%) the participants did not share the HIV self-testing kits with anyone. Many participants reported that HIV self-testing was empowering and reduced anxiety associated with waiting between clinic HIV tests.
  
  
  
  HIV self-testing was highly acceptable and may therefore be a feasible strategy to efficiently permit routine HIV testing between PrEP refills.
authors.affiliation: Department of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.|Department of Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ngure
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA, USA.|Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Heffron
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA, USA.|Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Nelly
authors.initials: N
authors.lastname: Mugo
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Kerry A
authors.initials: KA
authors.lastname: Thomson
authors.affiliation: Department of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Irungu
authors.affiliation: Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Njambi
authors.initials: N
authors.lastname: Njuguna
authors.affiliation: Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Mwaniki
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA, USA.|Department of Epidemiology, University of Washington, Seattle, WA, USA.|Departments of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Connie
authors.initials: C
authors.lastname: Celum
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA, USA.|Department of Epidemiology, University of Washington, Seattle, WA, USA.|Departments of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D059026:Diagnostic Self Evaluation; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control; D006801:Humans; D007630:Kenya; D008297:Male; D008403:Mass Screening; D065129:Pre-Exposure Prophylaxis; D012698:Serologic Tests; D012747:Sexual Partners
chemical_list: D019380:Anti-HIV Agents
keywords: Feasibility; HIV; Kenya; PrEP; acceptability; self-testing