Diagnostic accuracy and acceptability of oral HIV self – testing among adolescents and young people aged 18 to 35 years attending the most at Risk Population Clinic at Mulago Hospital, Kampala, Uganda

Abstract

Globally, HIV/AIDS is still one of the most devastating problems (Merson, O’Malley, Serwadda, & Apisuk, 2008) and 36.7 million people are living with HIV worldwide. Overtime, HIV testing remains a critical entry point for HIV prevention, treatment and care. Research has proven that Oral based HIV self – testing can reduce Sexual Risky Behaviors and increase testing frequency among key populations. (Martínez Pérez et al., 2016). Adequate evidence on the diagnostic performance of OraQuick® and its acceptability among the young people within the key population in Uganda aged 18 to 35 years is missing yet is needed at the moment to support and inform the implementation of Oral HIV self -testing (The World Health Organization, 2016). The study was a facility based and cross – sectional survey conducted at MARP clinic at Mulago Hospital in Kampala Uganda. A total of 105 participants was consecutively enrolled; 44% were female sex workers, 34% were men who have sex with men, 19% were people who inject with Drugs and 3% were others. 7 out of the 105 participants tested positive with Oral HIVST and 100% of these were found to be positive when tested with the national serial Algorithm. 104 (99.0%) correctly interpreted their Oral HIVST results and 1 participant (0.1%) had a false interpretation of their results. Of the 104 participants who had true interpretation of their results, 98 (94.2%) were HIV negative and 6 (5.8%) were HIV positive. Of the one participant who had a false interpretation of their results, 1 (100%) were HIV positive. With the sensitivity, specificity, predictive values and accuracy at 100.0%, oral HIV self – testing has an excellent diagnostic performance. Thus, it is an effective alternative to other HIV diagnostic methods used among adolescents and young people within the most at risk populations. Much as there was a high ability to correctly interpret Oral HIV self – testing resulting among the study participants, more awareness and surveillance on the use of oral HIV self – testing has to be done to ensure that the possibilities of false result interpretation are eliminated among people who use Oral HIV self – testing. Studies should be done to assess its feasibility and extents of linkage to the relevant and appropriate health services following Oral HIV self – testing among the most at risk adolescents and young people as well as investigate and document the impact of oral HIV self-testing without pre and post testing counseling on the management of the HIV pandemic in Uganda.