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Feasibility and Accuracy of HIV Testing of Children by Caregivers Using Oral Mucosal Transudate HIV Tests.

Authors :
Dziva Chikwari C
Simms V
Kranzer K
Dringus S
Chikodzore R
Sibanda E
Webb K
Redzo N
Mujuru H
Apollo T
Ncube G
Hatzold K
Bernays S
Weiss HA
Ferrand RA
Source :
Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2021 Jun 01; Vol. 87 (2), pp. 781-788.
Publication Year :
2021

Abstract

Background: Children encounter multiple barriers in accessing facilities. HIV self-testing using oral mucosal transudate (OMT) tests has been shown to be effective in reaching hard-to-reach populations. We evaluated the feasibility and accuracy of caregivers conducting HIV testing using OMTs in children in Zimbabwe.<br />Methods: We offered OMTs to caregivers (>18 years) living with HIV to test children (2-18 years) living in their households. All caregivers were provided with manufacturer instructions. In Phase 1 (January-December 2018, 9 clinics), caregivers additionally received a demonstration by a provider using a test kit and video. In Phase 2 (January-May 2019, 3 clinics), caregivers did not receive a demonstration. We collected demographic data and assessed caregiver's ability to perform the test and interpret results. Caregiver performance was assessed by direct observation and scored using a predefined checklist. Factors associated with obtaining a full score were analyzed using logistic regression.<br />Results: Overall 400 caregivers (83.0% female, median age 38 years) who were observed tested 786 children (54.6% female, median age 8 years). For most tests, caregivers correctly collected oral fluid [87.1% without provider demonstrations (n = 629) and 96.8% with demonstrations (n = 157), P = 0.002]. The majority correctly used a timer (90.3% without demonstrations and 96.8% with demonstrations, P = 0.02). In multivariate logistic regression caregivers who obtained a full score for performance were more likely to have received a demonstration (odds ratio 4.14, 95% confidence interval: 2.01 to 8.50).<br />Conclusions: Caregiver-provided testing using OMTs is a feasible and accurate HIV testing strategy for children. We recommend operational research to support implementation at scale.<br />Competing Interests: The authors have no conflicts of interest to disclose<br /> (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)

Details

Language :
English
ISSN :
1944-7884
Volume :
87
Issue :
2
Database :
MEDLINE
Journal :
Journal of acquired immune deficiency syndromes (1999)
Publication Type :
Academic Journal
Accession number :
33999014
Full Text :
https://doi.org/10.1097/QAI.0000000000002644