Accuracy and Acceptability of Oral Fluid HIV Self-Testing in a General Adult Population in Kenya

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.

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By: Kurth AE1, Cleland CM2, Chhun N2, Sidle JE3, Were E4,5, Naanyu V6,5, Emonyi W7,5, Macharia SM8,5, Sang E5, Siika AM9,5.

• 1New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10003, USA. akurth@nyu.edu.
• 2New York University College of Nursing, 433 First Avenue, 7th Floor, New York, NY, 10003, USA.
• 3Department of General Internal Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA.
• 4Department of Reproductive Health, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.
• 5Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
• 6Department of Behavioral Sciences, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.
• 7Department of Immunology, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.
• 8Moi Teaching and Referral Hospital, Eldoret, Kenya.
• 9Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya. 

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