Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe
Abstract Background There is limited data on client preferences for different HIV self-testing (HIVST) and provider-delivered testing options and associated factors. We explored client preferences for oral-fluid-based self-testing (OFBST), blood-based self-testing (BBST) and provider-delivered blood...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-023-08624-y |
| _version_ | 1797653537118748672 |
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| author | Webster Mavhu Memory Makamba Karin Hatzold Galven Maringwa Albert Takaruza Miriam Mutseta Getrude Ncube Frances M. Cowan Euphemia L. Sibanda |
| author_facet | Webster Mavhu Memory Makamba Karin Hatzold Galven Maringwa Albert Takaruza Miriam Mutseta Getrude Ncube Frances M. Cowan Euphemia L. Sibanda |
| author_sort | Webster Mavhu |
| collection | DOAJ |
| description | Abstract Background There is limited data on client preferences for different HIV self-testing (HIVST) and provider-delivered testing options and associated factors. We explored client preferences for oral-fluid-based self-testing (OFBST), blood-based self-testing (BBST) and provider-delivered blood-based testing (PDBBT) among different populations. Methods At clinics providing HIV testing services to general populations (1 urban, 1 rural clinic), men seeking voluntary medical male circumcision (VMMC, 1 clinic), and female sex workers (FSW, 1 clinic), clients had the option to test using OFBST, BBST or PDBBT. A pre-test questionnaire collected information on demographics and testing history. Two weeks after collecting a self-test kit, participants responded to a questionnaire. We used logistic regression to determine predictors of choices. We also conducted 20 in-depth interviews to contextualise quantitative findings. Results May to June 2019, we recruited 1244 participants of whom 249 (20%), 251 (20%), 244 (20%) and 500 (40%) were attending urban general, rural, VMMC and FSW clinics, respectively. Half (n = 619, 50%) chose OFBST, 440 (35%) and 185 (15%) chose BBST and PDBBT, respectively. In multivariable analysis comparing those choosing HIVST (OFBST and BBST combined) versus not, those who had never married aOR 0.57 (95% CI 0.34–0.93) and those previously married aOR0.56 (0.34–0.93) were less likely versus married participants to choose HIVST. HIVST preference increased with education, aOR 2.00 (1.28–3.13), 2.55 (1.28–5.07), 2.76 (1.48–5.14) for ordinary, advanced and tertiary education, respectively versus none/primary education. HIVST preference decreased with age aOR 0.97 (0.96–0.99). Urban participants were more likely than rural ones to choose HIVST, aOR 9.77 (5.47–17.41), 3.38 (2.03–5.62) and 2.23 (1.38–3.61) for FSW, urban general and VMMC clients, respectively. Comparing those choosing OFBST with those choosing BBST, less literate participants were less likely to choose oral fluid tests, aOR 0.29 (0.09–0.92). Conclusions Most testing clients opted for OFBST, followed by BBST and lastly, PDBBT. Those who self-assessed as less healthy were more likely to opt for PDBBT which likely facilitated linkage. Results show importance of continued provision of all strategies in order to meet needs of different populations, and may be useful to inform both HIVST kit stock projections and tailoring of HIVST programs to meet the needs of different populations. |
| first_indexed | 2024-03-11T16:46:00Z |
| format | Article |
| id | doaj.art-2a91f727bc474ebfa6d5a345cfce49a0 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-11T16:46:00Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-2a91f727bc474ebfa6d5a345cfce49a02023-10-22T11:07:08ZengBMCBMC Infectious Diseases1471-23342023-10-0122S111210.1186/s12879-023-08624-yPreferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in ZimbabweWebster Mavhu0Memory Makamba1Karin Hatzold2Galven Maringwa3Albert Takaruza4Miriam Mutseta5Getrude Ncube6Frances M. Cowan7Euphemia L. Sibanda8Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabwePopulation Services InternationalCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabwePopulation Solutions for HealthMinistry of Health and Child CareCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweCentre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweAbstract Background There is limited data on client preferences for different HIV self-testing (HIVST) and provider-delivered testing options and associated factors. We explored client preferences for oral-fluid-based self-testing (OFBST), blood-based self-testing (BBST) and provider-delivered blood-based testing (PDBBT) among different populations. Methods At clinics providing HIV testing services to general populations (1 urban, 1 rural clinic), men seeking voluntary medical male circumcision (VMMC, 1 clinic), and female sex workers (FSW, 1 clinic), clients had the option to test using OFBST, BBST or PDBBT. A pre-test questionnaire collected information on demographics and testing history. Two weeks after collecting a self-test kit, participants responded to a questionnaire. We used logistic regression to determine predictors of choices. We also conducted 20 in-depth interviews to contextualise quantitative findings. Results May to June 2019, we recruited 1244 participants of whom 249 (20%), 251 (20%), 244 (20%) and 500 (40%) were attending urban general, rural, VMMC and FSW clinics, respectively. Half (n = 619, 50%) chose OFBST, 440 (35%) and 185 (15%) chose BBST and PDBBT, respectively. In multivariable analysis comparing those choosing HIVST (OFBST and BBST combined) versus not, those who had never married aOR 0.57 (95% CI 0.34–0.93) and those previously married aOR0.56 (0.34–0.93) were less likely versus married participants to choose HIVST. HIVST preference increased with education, aOR 2.00 (1.28–3.13), 2.55 (1.28–5.07), 2.76 (1.48–5.14) for ordinary, advanced and tertiary education, respectively versus none/primary education. HIVST preference decreased with age aOR 0.97 (0.96–0.99). Urban participants were more likely than rural ones to choose HIVST, aOR 9.77 (5.47–17.41), 3.38 (2.03–5.62) and 2.23 (1.38–3.61) for FSW, urban general and VMMC clients, respectively. Comparing those choosing OFBST with those choosing BBST, less literate participants were less likely to choose oral fluid tests, aOR 0.29 (0.09–0.92). Conclusions Most testing clients opted for OFBST, followed by BBST and lastly, PDBBT. Those who self-assessed as less healthy were more likely to opt for PDBBT which likely facilitated linkage. Results show importance of continued provision of all strategies in order to meet needs of different populations, and may be useful to inform both HIVST kit stock projections and tailoring of HIVST programs to meet the needs of different populations.https://doi.org/10.1186/s12879-023-08624-yHIV self-testingFemale sex workersMenObservational studyZimbabwe |
| spellingShingle | Webster Mavhu Memory Makamba Karin Hatzold Galven Maringwa Albert Takaruza Miriam Mutseta Getrude Ncube Frances M. Cowan Euphemia L. Sibanda Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe BMC Infectious Diseases HIV self-testing Female sex workers Men Observational study Zimbabwe |
| title | Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe |
| title_full | Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe |
| title_fullStr | Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe |
| title_full_unstemmed | Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe |
| title_short | Preferences for oral-fluid-based or blood-based HIV self-testing and provider-delivered testing: an observational study among different populations in Zimbabwe |
| title_sort | preferences for oral fluid based or blood based hiv self testing and provider delivered testing an observational study among different populations in zimbabwe |
| topic | HIV self-testing Female sex workers Men Observational study Zimbabwe |
| url | https://doi.org/10.1186/s12879-023-08624-y |
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