Page 188 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 7 Original Research

Evaluation of a mobile application to

support HIV self-testing in Johannesburg,

South Africa

Authors: Background: Human immunodeficiency virus self-testing (HIVST) reduces barriers associated
Natasha Gous 1 with facility-based testing; however, no formal mechanism exists for users to self-report results
Alex E. Fischer 2 TM
Naleni Rhagnath or link to care. The Aspect HIVST mobile application (app) was developed for use in
2
Mothepane Phatsoane 2 South Africa.
Mohammed Majam
2
TM
Samanta T. Lalla-Edward 2 Objectives: This study evaluated the acceptability and feasibility of the Aspect HIVST app
for individuals from the inner city of Johannesburg.
Affiliations:
1 SystemOne, LLC, Method: This cross-sectional pilot, with a convenience sample of 300 adults, was conducted in
Weltevreden Park, July 2018. Participants were provided an OraQuick HIVST kit and a smartphone preloaded
South Africa with the app, then asked to follow the in-app instructions for use (IFU) to complete the HIVST
and upload results. Trained healthcare workers (HCWs) observed and recorded any deviations
2 Ezintsha, Wits Reproductive
Health and HIV Institute, from the IFU, and conducted a post-test survey to assess acceptability. Feasibility was evaluated
University of the by the number of participants who agreed to participate, completed the self-test, and uploaded
Witwatersrand, all information onto the app correctly.
Johannesburg, South Africa
Results: Most participants (98.7%) found the app easy to use. To reduce difficulties related to
Corresponding author: the IFU (26; 8.7%), participants suggested multimedia supplements (4; 1.3%), additional
Alex Fischer, languages (4; 1.3%) and simplified instructions (5; 1.7%). All individuals approached, agreed
[email protected]
to participate, 267 (89.0%) correctly completed all steps and 210 (78.7%) successfully captured
Dates: all information on the app. Most errors (26; 8.7%) were testing errors and 1 (0.3%) was from the
Received: 25 Mar. 2020 app sequence. Twelve (4.5%) errors were with test strip imaging and 72 (27.0%) discordances
Accepted: 23 Apr. 2020
Published: 30 June 2020 were with demographic information.
Conclusion: Despite some challenges with IFU interpretation and data capture via the app,
How to cite this article:
TM
Gous N, Fischer AE, this pilot showed that the Aspect HIVST app is an acceptable way to upload mobile HIVST
Rhagnath N, Phatsoane M, results and demographic information to a central database.
Majam M, Lalla-Edward ST.
Evaluation of a mobile Keywords: HIV self-test; digitisation; mobile app; monitoring and evaluation; digital health.
application to support HIV
self-testing in Johannesburg,
South Africa. S Afr J HIV Med. Introduction
2020;21(1):a1088. https://
doi.org/10.4102/sajhivmed. In 2012, the OraQuick ADVANCE Rapid HIV-1/2 Antibody Test (OraSure Technologies Inc,
v21i1.1088
Bethlehem, USA) was the first HIV self-test (HIVST) approved for sale in the United States as an
Copyright: over-the-counter HIVST rapid diagnostic test (RDT) for individuals with no prior HIV testing
© 2020. The Authors. experience. Since then, over 2.5 million HIVST kits have been sold globally and more than 4
1
Licensee: AOSIS. This work million have been distributed through donor funded programmes. The World Health Organization
2
is licensed under the (WHO) strongly recommends that HIVST be utilised as a way to complement existing HIV
Creative Commons
3
Attribution License. services as self-testing may reduce barriers associated with traditional facility-based testing, like
travel, wait times and privacy concerns. 4,5
Based on this growing body of evidence, South Africa became one of over 40 countries to have
6,7
incorporated HIV self-testing into their national HIV policies, with self-testing introduced as a
way to help close the gap between the 84.9% of adults living with HIV who know their HIV status
and the 90% target of the UNAIDS 90-90-90 initiative. 5,8,9,10 The introduction of HIVST programmes
will improve access to further HIV diagnostic services, prompting an increase in testing uptake
Read online: and frequency, which could lead to earlier diagnosis. 11
Read online:
Scan this QR
Scan this QR
code with your
code with your There are, however, several concerns related to HIVST, as there is no formal pipeline for users to
smart phone or
smart phone or
mobile device self-report their results or be linked to care following the self-test. These HIVST kits are not
mobile device
to read online.
to read online.
diagnostic, but rather considered tests for triage, and all positive results should prompt the user
http://www.sajhivmed.org.za 180 Open Access