The purpose of this study was
to understand high-risk young adults' use of the rapid human immunodeficiency
virus (HIV) self-test. The highest rate of new HIV infections occurs in people
between 15 and 24 years. Improving identification of young people infected
with HIV is a critical public health priority. The first rapid HIV self-testing
kit was approved in the US in 2012. Despite the product's promise, its use by
untrained young adults is not well-understood.
We conducted a mixed methods
study using surveys, a think-aloud protocol, observations, and in-depth
interviews. A systematic checklist was developed to assess participants' use of
the test. A total of 21 racial and/or ethnic minority young adults aged 18-24
participated in this study. Analysis of our interview data was guided by the
theory of reasoned action (TRA). Participants completed the initial procedures
of the test with a mean time of 8:36 min (range of 2:04'-16:33'). On a
14-point checklist, participants had a mean score of 10.8 (SD 2.26, range
3-14). In the qualitative analysis of the participants' interviews, guided by
the theoretical constructs of the TRA, the following themes emerged: "Did
I use it correctly?", "Can I trust the results?" (attitude);
"How will my partner react?!", "What will people think?"
(subjective norm); "Quick, easy and blood free," and "Avoids the
hassle of dealing with the healthcare system" (behavioral intention).
This
study provided evidence of the usefulness of the test perceived by young
adults, especially in light of their concerns about lack of privacy in medical
settings. Since many participants did not follow all of the instructions while
using the test, it is not evident that young adults can correctly use the HIV
self-test. Development of instructions manuals that are understandable and guide
proper use of medical devices is a great need, especially in the context of
home testing technology.
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By: Schnall R1, John RM2, Carballo-Dieguez A3.
1Columbia University, School of Nursing, 617 W. 168th
Street, New York, NY, 10032, USA. rb897@columbia.edu.
2Columbia University, School of Nursing, 617 W. 168th
Street, New York, NY, 10032, USA.
3Columbia University Medical Center, HIV Center for
Clinical and Behavioral Studies at New York State Psychiatric Institute, Unit
15, 1051 Riverside Drive, New York, NY, 10032, USA.
More at: https://twitter.com/hiv_insight
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