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Preferences and uptake of home-based HIV self-testing for maternal retesting in Kenya

Article scientifique 2024 Anglais

Résumé

Objective: To compare preferences, uptake, and cofactors for unassisted home-based oral self-testing (HB-HIVST) versus clinic-based rapid diagnostic blood tests (CB-RDT) for maternal HIV retesting. Design: Prospective cohort. Methods: Between November 2017 and June 2019, HIV-negative pregnant Kenyan women receiving antenatal care were enrolled and given a choice to retest with HB-HIVST or CB-RDT. Women were asked to retest between 36 weeks gestation and 1 week post-delivery if the last HIV test was <24 weeks gestation or at 6 weeks postpartum if ≥24 weeks gestation, and self-report on retesting at a 14 week postpartum. Results: Overall, 994 women enrolled and 33% (n=330) selected HB-HIVST. HB-HIVST was selected because it was private (68%), convenient (63%), and offered flexibility in timing of retesting (63%), whereas CB-RDT was selected due to trust of providers to administer the test (77%) and convenience of clinic testing (64%). Among 905 women who reported retesting at follow-up, 135 (15%) used HB-HIVST. Most (94%) who selected CB-RDT retested with this strategy, compared to 39% who selected HB-HIVST retesting with HB-HIVST. HB-HIVST retesting was more common among women with higher household income and those who may have been unable to test during pregnancy (both retested postpartum and delivered <37 weeks gestation) and less common among women who were depressed. Most women said they would retest in the future using the test selected at enrollment (99% HB-HIVST; 93% CB-RDT-RDT). Conclusions: While most women preferred CB-RDT for maternal retesting, HB-HIVST was acceptable and feasible and may increase retesting coverage and partner testing.

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Drake, A., Jiang, W., Kitao, P., Farid, S., Richardson, B., Katz, D., Wagner, A., Johnson, C., Matemo, D., Stewart, G., Kinuthia, J. (2024). Preferences and uptake of home-based HIV self-testing for maternal retesting in Kenya. https://doi.org/10.1101/2024.03.28.24305050

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Auteur(s)

Alison L. Drake Wenwen Jiang Peninah Kitao Shiza Farid Barbra A. Richardson David A. Katz Anjuli D. Wagner Cheryl Johnson Daniel Matemo Grace John Stewart John Kinuthia

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