Facility-based HIV Self-Testing

What Makes the Intervention Unique/Different:   Cluster-randomized controlled trial which found that offering facility-based HIVST in outpatient departments at high-volume health facilities increased the proportion of outpatients tested for HIV compared with standard and optimized PITC. The facility-based HIVST approach was very acceptable to participants and no coercion was reported.

Implementing Partner: Columbia University Mailman School of Public Health (ICAP)

Description: Facilities were randomized to either receive standard PITC, optimized PITC—which aimed to better integrate HIV testing services into outpatient departments—or an HIVST intervention. The HIVST intervention included providing a group demonstration and distribution of kits for use in private booths in the outpatient department.

Impact Data:  The study found a significant increase in the proportion of outpatients who were tested for HIV in the HIVST intervention group compared to the standard PITC and optimized PITC groups. There were high levels of acceptability for HIVST:

  • In the HIVST group, 51% of participants tested for HIV on the day of enrollment, compared with 13% in the standard PITC group and 14% in the optimized PITC group.
  • The odds of HIV testing were significantly higher in the facility-based HIVST group compared with standard PITC (adjusted odds ratio [aOR] 8.52, 95% confidence interval [CI] 3.98–18.24) or optimized PITC group (aOR 6.29, 95% CI 2.96–13.38).
  • Findings were similar across age and sex categories, with those aged 15–24 years showing the greatest benefit from facility-based HIVST compared with standard PITC (aOR 9.42, 95% CI 4.15–21.38).

Reference/Website:  https://icap.columbia.edu/tools_resources/february-march-2020-malawi-study-shows-more-outpatients-test-for-hiv-with-self-testing-option-compared-to-provider-initiated-testing-and-counseling-but-with-higher-cost-per-new-positive-case/