Uptake and Acceptability of Oral HIV Self-Testing among Community Pharmacy Clients in Kenya: A Feasibility Study
Identifieur interne : 000058 ( Main/Exploration ); précédent : 000057; suivant : 000059Uptake and Acceptability of Oral HIV Self-Testing among Community Pharmacy Clients in Kenya: A Feasibility Study
Auteurs : Peter M. Mugo [Kenya] ; Murugi Micheni [Kenya] ; Jimmy Shangala [Kenya] ; Mohamed H. Hussein [Kenya] ; Susan M. Graham [Kenya, États-Unis] ; Tobias F. Rinke De Wit [Pays-Bas] ; Eduard J. Sanders [Kenya, Pays-Bas, Royaume-Uni]Source :
- PLoS ONE [ 1932-6203 ] ; 2017.
Abstract
While HIV testing and counselling is a key entry point for treatment as prevention, over half of HIV-infected adults in Kenya are unaware they are infected. Offering HIV self-testing (HST) at community pharmacies may enhance detection of undiagnosed infections. We assessed the feasibility of pharmacy-based HST in Coastal Kenya.
Staff at five pharmacies, supported by on-site research assistants, recruited adult clients (≥18 years) seeking services indicative of HIV risk. Participants were offered oral HST kits (OraQuick®) at US$1 per test. Within one week of buying a test, participants were contacted for post-test data collection and counselling. The primary outcome was test uptake, defined as the proportion of invited clients who bought tests. Views of participating pharmacy staff were solicited in feedback sessions during and after the study.
Between November 2015 and April 2016, 463 clients were invited to participate; 174 (38%) were enrolled; and 161 (35% [95% Confidence Interval (CI) 31–39%]) bought a test. Uptake was higher among clients seeking HIV testing compared to those seeking other services (84% vs. 11%, adjusted risk ratio 6.9 [95% CI 4.9–9.8]). Only 4% of non-testers (11/302) stated inability to pay as the reason they did not take up the test. All but one tester reported the process was easy (29%) or very easy (70%). Demand for HST kits persisted after the study and participating service providers expressed interest in continuing to offer the service.
Pharmacy HST is feasible in Kenya and may be in high demand. The uptake pattern observed suggests that a client-initiated approach is more feasible compared to pharmacy-initiated testing. Price is unlikely to be a barrier if set at about US$1 per test. Further implementation research is required to assess uptake, yield, and linkage to care on a larger scale.
Url:
DOI: 10.1371/journal.pone.0170868
PubMed: 28125699
PubMed Central: 5268447
Affiliations:
- Kenya, Pays-Bas, Royaume-Uni, États-Unis
- Angleterre, Hollande-Septentrionale, Oxfordshire, Washington (État)
- Amsterdam, Oxford, Seattle
- Université d'Amsterdam, Université d'Oxford, Université de Washington
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Le document en format XML
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Mugo</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Kemri-Wellcome Trust Research Programme, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kemri-Wellcome Trust Research Programme, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Micheni, Murugi" sort="Micheni, Murugi" uniqKey="Micheni M" first="Murugi" last="Micheni">Murugi Micheni</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Kemri-Wellcome Trust Research Programme, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kemri-Wellcome Trust Research Programme, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Shangala, Jimmy" sort="Shangala, Jimmy" uniqKey="Shangala J" first="Jimmy" last="Shangala">Jimmy Shangala</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Kemri-Wellcome Trust Research Programme, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kemri-Wellcome Trust Research Programme, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation></author><author><name sortKey="Hussein, Mohamed H" sort="Hussein, Mohamed H" uniqKey="Hussein M" first="Mohamed H." last="Hussein">Mohamed H. Hussein</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Ministry of Health, Mombasa, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Ministry of Health, Mombasa</wicri:regionArea><wicri:noRegion>Mombasa</wicri:noRegion></affiliation></author><author><name sortKey="Graham, Susan M" sort="Graham, Susan M" uniqKey="Graham S" first="Susan M." last="Graham">Susan M. Graham</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Kemri-Wellcome Trust Research Programme, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kemri-Wellcome Trust Research Programme, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff003"><addr-line>University of Washington, Seattle, Washington, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Washington, Seattle, Washington</wicri:regionArea><placeName><region type="state">Washington (État)</region><settlement type="city">Seattle</settlement></placeName><orgName type="university">Université de Washington</orgName></affiliation></author><author><name sortKey="Rinke De Wit, Tobias F" sort="Rinke De Wit, Tobias F" uniqKey="Rinke De Wit T" first="Tobias F." last="Rinke De Wit">Tobias F. Rinke De Wit</name><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>University of Amsterdam, Amsterdam, the Netherlands</addr-line></nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region><settlement type="city">Amsterdam</settlement></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation></author><author><name sortKey="Sanders, Eduard J" sort="Sanders, Eduard J" uniqKey="Sanders E" first="Eduard J." last="Sanders">Eduard J. Sanders</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Kemri-Wellcome Trust Research Programme, Kilifi, Kenya</addr-line></nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kemri-Wellcome Trust Research Programme, Kilifi</wicri:regionArea><wicri:noRegion>Kilifi</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff004"><addr-line>University of Amsterdam, Amsterdam, the Netherlands</addr-line></nlm:aff><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>University of Amsterdam, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region><settlement type="city">Amsterdam</settlement></placeName><orgName type="university">Université d'Amsterdam</orgName></affiliation><affiliation wicri:level="4"><nlm:aff id="aff005"><addr-line>University of Oxford, Headington, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Oxford, Headington</wicri:regionArea><orgName type="university">Université d'Oxford</orgName><placeName><settlement type="city">Oxford</settlement><region type="nation">Angleterre</region><region type="région" nuts="1">Oxfordshire</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>While HIV testing and counselling is a key entry point for treatment as prevention, over half of HIV-infected adults in Kenya are unaware they are infected. Offering HIV self-testing (HST) at community pharmacies may enhance detection of undiagnosed infections. We assessed the feasibility of pharmacy-based HST in Coastal Kenya.</p></sec><sec id="sec002"><title>Methods</title><p>Staff at five pharmacies, supported by on-site research assistants, recruited adult clients (≥18 years) seeking services indicative of HIV risk. Participants were offered oral HST kits (OraQuick®) at US$1 per test. Within one week of buying a test, participants were contacted for post-test data collection and counselling. The primary outcome was test uptake, defined as the proportion of invited clients who bought tests. Views of participating pharmacy staff were solicited in feedback sessions during and after the study.</p></sec><sec id="sec003"><title>Results</title><p>Between November 2015 and April 2016, 463 clients were invited to participate; 174 (38%) were enrolled; and 161 (35% [95% Confidence Interval (CI) 31–39%]) bought a test. Uptake was higher among clients seeking HIV testing compared to those seeking other services (84% vs. 11%, adjusted risk ratio 6.9 [95% CI 4.9–9.8]). Only 4% of non-testers (11/302) stated inability to pay as the reason they did not take up the test. All but one tester reported the process was easy (29%) or very easy (70%). Demand for HST kits persisted after the study and participating service providers expressed interest in continuing to offer the service.</p></sec><sec id="sec004"><title>Conclusions</title><p>Pharmacy HST is feasible in Kenya and may be in high demand. The uptake pattern observed suggests that a client-initiated approach is more feasible compared to pharmacy-initiated testing. Price is unlikely to be a barrier if set at about US$1 per test. Further implementation research is required to assess uptake, yield, and linkage to care on a larger scale.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Cohen, Ms" uniqKey="Cohen M">MS Cohen</name></author><author><name sortKey="Smith, Mk" uniqKey="Smith M">MK Smith</name></author><author><name sortKey="Muessig, Ke" uniqKey="Muessig K">KE Muessig</name></author><author><name sortKey="Hallett, Tb" uniqKey="Hallett T">TB Hallett</name></author><author><name sortKey="Powers, Ka" uniqKey="Powers K">KA Powers</name></author><author><name sortKey="Kashuba, Ad" uniqKey="Kashuba A">AD Kashuba</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosenberg, Ne" uniqKey="Rosenberg N">NE Rosenberg</name></author><author><name sortKey="Pettifor, Ae" uniqKey="Pettifor A">AE Pettifor</name></author><author><name sortKey="De Bruyn, G" uniqKey="De Bruyn G">G De Bruyn</name></author><author><name 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sortKey="Klepser, Sa" uniqKey="Klepser S">SA Klepser</name></author><author><name sortKey="Reeves, A" uniqKey="Reeves A">A Reeves</name></author><author><name sortKey="Young, M" uniqKey="Young M">M Young</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mugo, Pm" uniqKey="Mugo P">PM Mugo</name></author><author><name sortKey="Prins, Ha" uniqKey="Prins H">HA Prins</name></author><author><name sortKey="Wahome, Ew" uniqKey="Wahome E">EW Wahome</name></author><author><name sortKey="Mwashigadi, Gm" uniqKey="Mwashigadi G">GM Mwashigadi</name></author><author><name sortKey="Thiong O, An" uniqKey="Thiong O A">AN Thiong'o</name></author><author><name sortKey="Gichuru, E" uniqKey="Gichuru E">E Gichuru</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Heard, Ac" uniqKey="Heard A">AC Heard</name></author><author><name sortKey="Brown, An" uniqKey="Brown A">AN Brown</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thirumurthy, H" uniqKey="Thirumurthy H">H Thirumurthy</name></author><author><name sortKey="Masters, Sh" uniqKey="Masters S">SH Masters</name></author><author><name sortKey="Mavedzenge, Sn" uniqKey="Mavedzenge S">SN Mavedzenge</name></author><author><name sortKey="Maman, S" uniqKey="Maman S">S Maman</name></author><author><name sortKey="Omanga, E" uniqKey="Omanga E">E Omanga</name></author><author><name sortKey="Agot, K" uniqKey="Agot K">K Agot</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Ngure, K" uniqKey="Ngure K">K Ngure</name></author><author><name sortKey="Renee, H" uniqKey="Renee H">H Renee</name></author><author><name sortKey="Mugo, N" uniqKey="Mugo N">N Mugo</name></author><author><name sortKey="Irungu, E" uniqKey="Irungu E">E Irungu</name></author><author><name sortKey="Njuguna, N" uniqKey="Njuguna N">N Njuguna</name></author><author><name sortKey="Mwaniki, L" uniqKey="Mwaniki L">L Mwaniki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mugo, Pm" uniqKey="Mugo P">PM Mugo</name></author><author><name sortKey="Duncan, S" uniqKey="Duncan S">S Duncan</name></author><author><name sortKey="Mwaniki, Sw" uniqKey="Mwaniki S">SW Mwaniki</name></author><author><name sortKey="Thiong O, An" uniqKey="Thiong O A">AN Thiong'o</name></author><author><name sortKey="Gichuru, E" uniqKey="Gichuru E">E Gichuru</name></author><author><name sortKey="Okuku, Hs" uniqKey="Okuku H">HS Okuku</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Cummings, P" uniqKey="Cummings P">P Cummings</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wood, Br" uniqKey="Wood B">BR Wood</name></author><author><name sortKey="Ballenger, C" uniqKey="Ballenger C">C Ballenger</name></author><author><name sortKey="Stekler, Jd" uniqKey="Stekler J">JD Stekler</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Kenya</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Hollande-Septentrionale</li><li>Oxfordshire</li><li>Washington (État)</li></region><settlement><li>Amsterdam</li><li>Oxford</li><li>Seattle</li></settlement><orgName><li>Université d'Amsterdam</li><li>Université d'Oxford</li><li>Université de Washington</li></orgName></list><tree><country name="Kenya"><noRegion><name sortKey="Mugo, Peter M" sort="Mugo, Peter M" uniqKey="Mugo P" first="Peter M." last="Mugo">Peter M. Mugo</name></noRegion><name sortKey="Graham, Susan M" sort="Graham, Susan M" uniqKey="Graham S" first="Susan M." last="Graham">Susan M. Graham</name><name sortKey="Hussein, Mohamed H" sort="Hussein, Mohamed H" uniqKey="Hussein M" first="Mohamed H." last="Hussein">Mohamed H. Hussein</name><name sortKey="Micheni, Murugi" sort="Micheni, Murugi" uniqKey="Micheni M" first="Murugi" last="Micheni">Murugi Micheni</name><name sortKey="Sanders, Eduard J" sort="Sanders, Eduard J" uniqKey="Sanders E" first="Eduard J." last="Sanders">Eduard J. Sanders</name><name sortKey="Shangala, Jimmy" sort="Shangala, Jimmy" uniqKey="Shangala J" first="Jimmy" last="Shangala">Jimmy Shangala</name></country><country name="États-Unis"><region name="Washington (État)"><name sortKey="Graham, Susan M" sort="Graham, Susan M" uniqKey="Graham S" first="Susan M." last="Graham">Susan M. Graham</name></region></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Rinke De Wit, Tobias F" sort="Rinke De Wit, Tobias F" uniqKey="Rinke De Wit T" first="Tobias F." last="Rinke De Wit">Tobias F. Rinke De Wit</name></region><name sortKey="Sanders, Eduard J" sort="Sanders, Eduard J" uniqKey="Sanders E" first="Eduard J." last="Sanders">Eduard J. Sanders</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Sanders, Eduard J" sort="Sanders, Eduard J" uniqKey="Sanders E" first="Eduard J." last="Sanders">Eduard J. Sanders</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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