HIV self-test reporting using mHealth platforms: A pilot study in Johannesburg, South Africa

Mothepane Phatsoane Gaven; Matthew Quaife; Mohammed Majam; Leanne Singh; Naleni Rhagnath; Theodore Wonderlik; Siphamandla Bonga Gumede

doi:10.3389/frph.2023.1073492

HIV self-test reporting using mHealth platforms: A pilot study in Johannesburg, South Africa

Front Reprod Health. 2023 Feb 27:5:1073492. doi: 10.3389/frph.2023.1073492. eCollection 2023.

Authors

Mothepane Phatsoane Gaven¹, Matthew Quaife², Mohammed Majam¹, Leanne Singh¹, Naleni Rhagnath¹, Theodore Wonderlik¹, Siphamandla Bonga Gumede^{1

3}

Affiliations

¹ Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
² Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom.
³ Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands.

Abstract

Background: The main impediment to operational scale-up of HIV self-testing (HIVST) and counselling, is a dearth of information on utilisation, reporting, and linkage to care for HIV-positive individuals. To inform solutions to this issue, this study investigated the utility of self-testers reporting their results using a mobile-health (mHealth) platform, and whether seropositive users linked into care.

Method: Candidates who met the recruitment criteria across multiple sites within inner-city Johannesburg each received an HIVST kit. Using short message service (SMS) reminders (50% standard and 50% behavioural science), participants were prompted to self-report results on provided platforms. On the seventh day, users who did not make contact, were called, and surveyed via an interactive voice response system (IVRS). Multivariable regression was used in reporting by age and sex.

Results: Of the 9,505 participants, 2,467 (25.9%) participants answered any survey question, and of those, 1,933 (78.4%) were willing to self-report their HIV status. Men were more likely than women to make an inbound call (10.2% vs. 9.1%, p = 0.06) however, women were significantly more likely to self-report their test result (AOR = 1.12, 95%CI = 1.01-1.24, p = 0.025). Overall, self-reporting a test result was predicted by being younger and female. In addition, reporting HIV results was associated with age, 25-35 (AOR = 1.58, 95% CI = 1.24-2.02) and above 35 years (AOR = 2.12, 95% CI = 1.61-2.80). Out of 1,933 participants willing to report their HIV status, 314 reported a positive test, indicating a HIV prevalence of 16.2% (95% CI: 14.6%-18.0%) and of those 204 (65.0%) reported inclination to link to care.

Conclusion: While self-reporting HIVST results via an IVRS system yielded a higher response rate, behavioural SMSs were ineffective in increasing self-reporting.

Keywords: HIV care; HIV self-testing; HIV testing services; IVRS; linkage; monitoring and evaluation; short message services.

Grants and funding

The study was funded by AIDS Fonds (P10911) and Bill and Melinda Gates Foundation (OPP1132929). Both OraQuick (oral based) and INSTI (blood based) HIV testing kits were procured from Orasure Technologies and Biolytical Laboratories. No funder or industry partner was involved in the design or analysis of the project, nor have they contributed or reviewed the manuscript before submission.