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An Implementation study of oral and blood-based HIV self-testing and linkage to care among men in rural and peri-urban KwaZulu-Natal, South Africa

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dc.date.accessioned 2020-09-14T09:15:06Z
dc.date.available 2020-09-14T09:15:06Z
dc.date.issued 2020-08-06 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/15369
dc.description.abstract In South Africa, men living with HIV are less likely than women to test and know their status (the first UNAIDS 90-90-90 target), and men have worse outcomes across the HIV care cascade. HIV self-testing (HIVST) may address this testing disparity but questions remain over the most effective distribution strategy and linkage following a positive test result. We implemented a men-focused HIVST distribution programme to evaluate components contributing to participation and retention. We conducted an implementation study of multi-venue HIVST kit distribution in rural and peri-urban Kwa-Zulu Natal (KZN), South Africa. We distributed HIVST kits at community points, workplaces and social venues for on site or takehome use. Clients could choose blood-based or oral-fluid-based HIVST kits and elect to watch an in-person or video demonstration. We provided a USD2 incentive to facilitate reporting test results by phone or SMS. Persons with reactive HIVST results were provided immediate confirmatory tests (if used HIVST on site) or were referred for confirmatory testing (if took HIVST off site) and linkage to care for antiretroviral therapy (ART) initiation. We describe the testing and linkage cascade in this sample and describe predictors of reactive HIVST results and linkage. Between July and November 2018, we distributed 4496 HIVST kits in two regions of KZN (96% to men, median age 28 (IQR 23 to 35). Most participants (58%) chose blood-based HIVST and 42% chose oral-swab kits. 11% of men were testing for the first time. A total of 3902 (83%) of testers reported their test result to the study team, with 314 (8%) screening positive for HIV. Among 274 men with reactive HIVST results, 68% linked to ART; no significant predictors of linkage were identified. 10% of kit users reported they would prefer a different type (oral vs. blood) of kit for repeat testing than the type they used. HIVST is acceptable to men and rapid distribution with optional testing support is feasible in rural and periurban settings. HIVST kits successfully reached younger men and identified undetected infections. Both oral and blood-based HIVST were selected. Scaling up HIVST distribution and guidance may increase the number of first-time testers among men and help achieve the first UNAIDS 90 for men in South Africa. en
dc.format.medium Print en
dc.subject HIV/AIDS en
dc.subject KWAZULU-NATAL en
dc.subject RURAL AREAS en
dc.subject SELF-TESTING en
dc.subject PERI-URBAN SETTLEMENTS en
dc.subject MEN en
dc.title An Implementation study of oral and blood-based HIV self-testing and linkage to care among men in rural and peri-urban KwaZulu-Natal, South Africa en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber SOANAA en
dc.Volume 23(S2) en
dc.BudgetYear 2020/21 en
dc.ResearchGroup Human and Social Capabilities en
dc.ResearchGroup Impact Centre en
dc.ResearchGroup Developmental, Capable and Ethical State en
dc.SourceTitle Journal of the International AIDS Society en
dc.ArchiveNumber 11431 en
dc.PageNumber 35-42 en
dc.outputnumber 10603 en
dc.bibliographictitle Shapiro, A.E., Van Heerden, A., Krows, M., Sausi, K., Sithole, N., Schaafsma, T.T., Koole, O., Van Rooyen, H., Celum, C.L. & Barnabas, R.V. (2020) An Implementation study of oral and blood-based HIV self-testing and linkage to care among men in rural and peri-urban KwaZulu-Natal, South Africa. <i>Journal of the International AIDS Society</i>. 23(S2):35-42. en
dc.publicationyear 2020 en
dc.contributor.author1 Shapiro, A.E. en
dc.contributor.author2 Van Heerden, A. en
dc.contributor.author3 Krows, M. en
dc.contributor.author4 Sausi, K. en
dc.contributor.author5 Sithole, N. en
dc.contributor.author6 Schaafsma, T.T. en
dc.contributor.author7 Koole, O. en
dc.contributor.author8 Van Rooyen, H. en
dc.contributor.author9 Celum, C.L. en
dc.contributor.author10 Barnabas, R.V. en


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