HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults

Zanolini, Arianna; Chipungu, Jenala; Vinikoor, Michael J.; Bosomprah, Samuel; Mafwenko, Mazuba; Holmes, Charles B.; & Thirumurthy, Harsha. (Forthcoming). HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults. AIDS Research and Human Retroviruses.

Zanolini, Arianna; Chipungu, Jenala; Vinikoor, Michael J.; Bosomprah, Samuel; Mafwenko, Mazuba; Holmes, Charles B.; & Thirumurthy, Harsha. (Forthcoming). HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults. AIDS Research and Human Retroviruses.

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Background: We assessed attitudes and preferences towards HIV self-testing (HIVST) among Zambian adolescents and adults. Methods: We conducted a population-based survey of individuals aged 16-49 years old in Lusaka Province, Zambia. HIVST was shown to participants through a short video on oral fluid-based self-testing. In addition to demographics, HIV risk perceptions, and HIV testing history, we assessed participants' acceptability and concerns regarding HIVST. Using a discrete choice experiment, we investigated preferences for the location of self-test pickup, availability of counseling, and cost. After reviewing an instructional sheet or an additional video, we assessed participants' understanding of self-test performance. Results: Among 1617 participants, 647 (40.0%) were men, 269 (16.6%) were adolescents and 754 (46.6%) were non-testers (i.e., no HIV test in the past 12 months). After viewing the video, 1392 (86.0%) reported that HIVST would make them more likely to test and while 35.0% reported some concerns with HIVST, only 2% were serious concerns. Participants strongly preferred HIVST over finger prick testing as well as having counseling and reported willingness to pay out-of-pocket (US$3.5 for testers and US$5.5 for non-testers). Viewing an HIVST demonstration video did not improve participant understanding of self-test usage procedures compared to an instructional sheet alone, but it increased confidence in the ability to self-test. Conclusions: HIVST was highly acceptable and desirable, especially among those not accessing existing HIV testing services. Participants expressed a strong preference for counseling and a willingness to pay for test kits. These data can guide piloting and scaling-up of HIVST in Zambia and elsewhere in Africa.




JOUR



Zanolini, Arianna
Chipungu, Jenala
Vinikoor, Michael J.
Bosomprah, Samuel
Mafwenko, Mazuba
Holmes, Charles B.
Thirumurthy, Harsha



Forthcoming


AIDS Research and Human Retroviruses













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