Acceptability of HIV self-testing to support pre-exposure prophylaxis among female sex workers in Uganda and Zambia: results from two randomized controlled trials

• Published in: BMC infectious diseases 2018-10, Vol.18 (1), p.503-503, Article 503
• Main Authors: Ortblad, Katrina F, Chanda, Michael M, Musoke, Daniel Kibuuka, Ngabirano, Thomson, Mwale, Magdalene, Nakitende, Aidah, Chongo, Steven, Kamungoma, Nyambe, Kanchele, Catherine, Bärnighausen, Till, Oldenburg, Catherine E
• Format: Article
• Language: English
• Subjects: Acceptability; Acquired immune deficiency syndrome; AIDS; Analysis; Antibiotic prophylaxis; Bisexuality; Clinical trials; Female sex workers; Health aspects; Health care; HIV; HIV infections; HIV self-testing; HIV tests; Human immunodeficiency virus; Infectious diseases; Management; Medical tests; Methods; Occupational exposure; Occupational health; Pre-exposure prophylaxis; Prevention; Prophylaxis; Prostitutes; Prostitution; Randomization; Regression analysis; Regression models; Self care (Health); Self testing; Self tests; Sex; Sex industry; Sexually transmitted diseases; STD; Uganda; Workers; Zambia
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-018-3415-z

HIV pre-exposure prophylaxis (PrEP) is highly effective for prevention of HIV acquisition, but requires HIV testing at regular intervals. Female sex workers (FSWs) are a priority population for HIV prevention interventions in many settings, but face barriers to accessing healthcare. Here, we assessed the acceptability of HIV self-testing for regular HIV testing during PrEP implementation among FSWs participating in a randomized controlled trial of HIV self-testing delivery models. We used data from two HIV self-testing randomized controlled trials with identical protocols in Zambia and in Uganda. From September-October 2016, participants were randomized in groups to: (1) direct delivery of an HIV self-test, (2) delivery of a coupon, exchangeable for an HIV self-test at nearby health clinics, or (3) standard HIV testing services. Participants completed assessments at baseline and 4 weeks. Participants reporting their last HIV test was negative were asked about their interest in various PrEP modalities and their HIV testing preferences. We used mixed effects logistic regression models to measure differences in outcomes across randomization arms at four weeks. At 4 weeks, 633 participants in Zambia and 749 participants in Uganda reported testing negative at their last HIV test. The majority of participants in both studies were "very interested" in daily oral PrEP (91% Zambia; 66% Uganda) and preferred HIV self-testing to standard testing services while on PrEP (87% Zambia; 82% Uganda). Participants in the HIV self-testing intervention arms more often reported preference for HIV self-testing compared to standard testing services to support PrEP in both Zambia (P = 0.002) and Uganda (P