Acceptability, feasibility, and accuracy of blood-based HIV self-testing: A cross-sectional study in Ho Chi Minh City, Vietnam

Bao Vu Ngoc; Mohammed Majam; Kimberly Green; Ton Tran; Minh Tran Hung; Anh Luong Que; Diep Bui Ngoc; Chuong Hoang Le Duy

doi:10.1371/journal.pgph.0001438

Acceptability, feasibility, and accuracy of blood-based HIV self-testing: A cross-sectional study in Ho Chi Minh City, Vietnam

PLOS Glob Public Health. 2023 Feb 1;3(2):e0001438. doi: 10.1371/journal.pgph.0001438. eCollection 2023.

Authors

Bao Vu Ngoc¹, Mohammed Majam², Kimberly Green¹, Ton Tran³, Minh Tran Hung⁴, Anh Luong Que³, Diep Bui Ngoc⁴, Chuong Hoang Le Duy³

Affiliations

¹ PATH, Hanoi, Vietnam.
² Ezintsha, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa.
³ Pasteur Institute, Ho Chi Minh City, Vietnam.
⁴ Center for Creative Initiatives in Health and Population, Hanoi, Vietnam.

Abstract

HIV self-testing (HIVST) is an effective approach to increase testing uptake. While oral fluid-based HIVST has been rapidly scaled, use of blood-based HIVST remains limited. We evaluated the acceptability, feasibility, and accuracy of blood-based HIVST among lay users in Ho Chi Minh City (HCMC), Vietnam. We conducted a cross-sectional study among HIV testing clients at the HCMC Pasteur Institute from March 2019 to October 2020. Participants received one HIVST kit and performed the test in front of an observer. The observer used product-specific questionnaires to collect information on the HIVST process, test results, experiences. The participants' interpretations of HIVST results were compared to health staff's interpretations and gold standard laboratory EIA reference tests. Of 2,399 participants who accepted HIVST, 64.7% were men, 62.1% aged 25-49 years, 53.5% had a higher education level, 41.4% were employed, and 35.6% were first-time testers. The vast majority (94.4%) desired to use the test in the future, and 93.9% reported willingness to recommend the test. The majority (90.8%) of participants successfully completed the self-test. One factor associated with successful completion was higher education level (aOR = 1.85; 95% CI: 1.32-2.61); while participants self-testing with SURE CHECK (aOR = 0.21; 95% CI: 0.12-0.37), INSTI (aOR = 0.23; 95% CI: 0.13-0.39), and BioSURE (aOR = 0.29; 95% CI: 0.17-0.51) or being unemployed, retired, or doing housework (aOR = 0.45; 95% CI: 0.25-0.82) were less likely to perform the test successfully. Agreement of positive and negative HIVST results as interpreted by participants and health staff was high (98.1% and 99.9%, respectively). Sensitivity and specificity of the evaluated HIVST were 96.43% (95% CI: 93.62-99.23) and 99.9% (95% CI: 99.75-100), respectively. Our findings confirm that blood-based HIVST is highly acceptable, feasible, and accurate. This evidence informs scale-up of HIVST to increase uptake of essential HIV prevention and treatment services.

Copyright: © 2023 Ngoc et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This work was supported by the Bill & Melinda Gates Foundation (OPP1132929 to MM; subagreement between Wits Reproductive Health and HIV Institute - A division of Wits Health Consortium (Pty) Ltd and PATH to BVN, KG, TT, MTH, ALQ,DBN, CHLD). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.