Abstract
IntroductionHIV self-testing could add a new approach to scaling up HIV testing with potential of being high impact, low cost, confidential, and empowering for users.MethodsPregnant women attending antenatal clinics (ANC) and their male partners were recruited in 14 clinics in the eastern and central regions of Kenya and randomly allocated to intervention or control arms at a ratio of 1:1:1. Arm 1 received the standard of care, which involved invitation of the male partner to the clinic through word of mouth, arm 2 received an improved invitation letter, and arm 3 received the same improved letter and, two self-testing kits. Analysis was done using adjusted odds ratios (aOR) at 95% confidence intervals (CI) to calculate and determine effects of HIV self-testing in increasing uptake of male partner testing.ResultsA total of 1410 women and 1033 men were recruited; 86% (1217) women and 79% (1107) couples were followed up. In arm 3, over 80% (327) of male partners took HIV test, compared to only 37% (133) in arm 2 and 28% (106) in arm one. There was a statistical significance between arm one and two (p-value=0.01) while arm three was statistically significant compared to arm two (p-value<0.001). Men in arm three were twelve times more likely to test compared to arm one (aOR 12.45 (95% CI 7.35, 21.08)).ConclusionGiving ANC mothers test kits and improved male invitation letter increased the likelihood of male partner testing by twelve times. These results demonstrate that HIV self-test kits could complement routine HIV testing methods in the general population.
Highlights
HIV self-testing could add a new approach to scaling up HIV testing with potential of being high impact, low cost, confidential, and empowering for users
HIV and AIDS prevalence peaked at 11% in the mid-nineties and has since dropped and stabilized to below 5.6% in 2012 due to mainly rapid scale up of various HIV interventions that included HIV care and treatment, Prevention of Mother to Child Transmission (PMTCT), Voluntary Medical Male Circumcision (VMMC), HIV Testing and Counselling (HTC) among other evidence based interventions [2]
Kenya has in the recent years adapted and included in the national HIV Testing Services (HTS) guidelines, HIV self-testing approach which is defined as any form of testing in which an individual collects his or her own sample performs a simple HIV test; and is, the first to know the results
Summary
HIV self-testing could add a new approach to scaling up HIV testing with potential of being high impact, low cost, confidential, and empowering for users. Conclusion: giving ANC mothers test kits and improved male invitation letter increased the likelihood of male partner testing by twelve times. These results demonstrate that HIV self-test kits could complement routine HIV testing methods in the general population. Self-testing could add a new approach to support scaling up testing with a potential to be high impact, low cost, confidential, and empowering for users. Male partners influence women's treatment decisions, including whether she receives medication [10] and whether she adheres to infant feeding advice [11]
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