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

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Zanolini, Arianna; Chipungu, Jenala; Vinikoor, Michael J.; Bosomprah, Samuel; Mafwenko, Mazuba; Holmes, Charles B.; & Thirumurthy, Harsha (2018). 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, 34(3), 254-260. PMCID: PMC5863088

Abstract

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.

URL

http://dx.doi.org/10.1089/aid.2017.0156

Reference Type

Journal Article

Year Published

2018

Journal Title

AIDS Research and Human Retroviruses

Author(s)

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

PMCID

PMC5863088