Accuracy of un-supervised versus provider-supervised self-administered HIV testing in Uganda: A randomized implementation trial

AIDS Behav. 2014 Dec;18(12):2477-84. doi: 10.1007/s10461-014-0765-4.


Unsupervised HIV self-testing (HST) has potential to increase knowledge of HIV status; however, its accuracy is unknown. To estimate the accuracy of unsupervised HST in field settings in Uganda, we performed a non-blinded, randomized controlled, non-inferiority trial of unsupervised compared with supervised HST among selected high HIV risk fisherfolk (22.1 % HIV Prevalence) in three fishing villages in Uganda between July and September 2013. The study enrolled 246 participants and randomized them in a 1:1 ratio to unsupervised HST or provider-supervised HST. In an intent-to-treat analysis, the HST sensitivity was 90 % in the unsupervised arm and 100 % among the provider-supervised, yielding a difference 0f -10 % (90 % CI -21, 1 %); non-inferiority was not shown. In a per protocol analysis, the difference in sensitivity was -5.6 % (90 % CI -14.4, 3.3 %) and did show non-inferiority. We conclude that unsupervised HST is feasible in rural Africa and may be non-inferior to provider-supervised HST.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Directive Counseling*
  • Feasibility Studies
  • Female
  • HIV Seropositivity / diagnosis*
  • HIV Seropositivity / epidemiology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Mass Screening
  • Patient Acceptance of Health Care
  • Patient Education as Topic
  • Prevalence
  • Reagent Kits, Diagnostic* / standards
  • Reproducibility of Results
  • Self Care*
  • Sexual Partners*
  • Surveys and Questionnaires
  • Uganda / epidemiology


  • Reagent Kits, Diagnostic