scholarly journals Analytical Performance of the Exacto Test HIV Self-Test: A Cross-Sectional Field Study in the Democratic Republic of the Congo

2020 ◽  
Vol 7 (12) ◽  
Author(s):  
Serge Tonen-Wolyec ◽  
Jérémie Muwonga Masidi ◽  
Luc Ferdinand Kamanga Lukusa ◽  
Gaetan Nsiku Dikumbwa ◽  
Angèle Sarassoro ◽  
...  
Keyword(s):  
Field Study ◽  
Democratic Republic ◽  
Analytical Performance ◽  
Viable Option ◽  
Excellent Performance ◽  
Cross Sectional ◽  
Performance Sensitivity ◽  
Self Testing ◽  
Republic Of The Congo ◽  
Self Test

Abstract The Democratic Republic of the Congo (DRC) has begun implementing HIV self-testing to boost the first “95” of the UNAIDS 95-95-95 targets by 2025. This study aims to assess the performance and usability of the Exacto Test HIV (Biosynex, Strasbourg, France) self-test in the lab and in the field. The Exacto Test HIV self-test demonstrated high virological performance (sensitivity, 99.6%; specificity, 100%) in the lab and in the field in the hand of untrained users (sensitivity, 100%; specificity, 98.9%). Taken together, the excellent performance and usability characteristics of the Exacto Test HIV (Biosynex) self-test make the kit a viable option for HIV self-testing in the DRC.

scholarly journals Comparison of practicability and effectiveness between unassisted HIV self-testing and directly assisted HIV self-testing in the Democratic Republic of the Congo: A randomized feasibility trial

2020 ◽  
Author(s):  
Serge Tonen-Wolyec ◽  
Charles Kayembe Tshilumba ◽  
Salomon Batina-Agasa ◽  
Roland Marini Djang’eing’a ◽  
Marie-Pierre Hayette ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Democratic Republic ◽  
Linkage To Care ◽  
Feasibility Trial ◽  
Test Results ◽  
Self Testing ◽  
Willingness To Buy ◽  
Republic Of The Congo ◽  
Self Test

Abstract Background. HIV self-testing (HIVST) can be performed using directly assisted and unassisted approaches in facilities or communities to reach different populations. The aim of this study was to compare the practicability and effectiveness of the two delivery approaches for HIVST, unassisted HIVST (UH) and directly assisted HIVST (DAH), in the field setting of Kisangani, the Democratic Republic of the Congo (DRC).Methods. A randomized (1:1), non-blinded, non-inferiority trial using a blood-based and facility-based HIVST method was carried out in four facilities in Kisangani, the DRC, targeting populations at high risk for HIV infection. The primary outcome was the difference in the practicability of the HIV self-test between the two arms. Practicability was defined as successfully performing the test and correctly interpreting the result. Requests for assistance, positivity rate, linkage to care, and willingness to buy an HIV self-test kit constituted the secondary outcomes for HIVST effectiveness. The adjusted risk ratios (aRRs) were calculated using Poisson regression. Results. The rate of successfully performing the test was same (93.2%) in the UH and DAH arms. The rate of correctly interpreting the results was 86.9% in the UH arm versus 93.2% in the DAH arm, for a difference of -6.3%. After the follow-up 72 h later, participants in the UH arm had a significantly lower chance of correctly interpreting the test results than those in the DAH arm (aRR: 0.60; P=0.019). Although the positivity rate was 3.4% among the participants in the DAH arm and 1.7% among those in the UH arm, no significant differences were found between the two arms in the positivity rate, requests for assistance, and linkage to care. Willingness to buy an HIV self-test was higher in the UH arm than in the DAH arm (92.3% versus 74.1%; aRR: 4.20; P<0.001). Conclusion. The results of this study indicate that UH is as practicable and effective as DAH among individuals at high risk for HIV infection in Kisangani, the DRC. However, additional support tools need to be assessed to improve the interpretation of the self-test results when using the UH approach. Trial registration: PACTR201904546865585. Registered 03 April 2019 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=6032

scholarly journals Practicability and effectiveness of the unassisted HIV self-testing compared to the directly assisted HIV self-testing in  the Democratic Republic of the Congo:  A Randomized Implementation Trial

2020 ◽  
Author(s):  
Serge Tonen-Wolyec ◽  
Charles Kayembe Tshilumba ◽  
Salomon Batina-Agasa ◽  
Roland Marini Djang’eing’a ◽  
Marie-Pierre Hayette ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Linkage To Care ◽  
Correct Interpretation ◽  
Successful Performance ◽  
Self Testing ◽  
Willingness To Buy ◽  
Significant Difference ◽  
Republic Of The Congo ◽  
Self Test ◽  
Additional Support

Abstract Background. HIV self-testing (HIVST) may be use free or assisted by health care workers. The aim of this trial was to assess the practicability and effectiveness of unassisted HIVST (UH) versus directly assisted HIVST (DAH) in field settings in the Democratic Republic of the Congo (DRC). Methods. A non-inferiority evaluation using a blood-based HIV self-test was conducted in Kisangani, DRC. Participants were randomized in a 1:1 ratio to UH or DAH. Practicability was defined as the successful performance and the correct interpretation of the result. The linkage to care and the willingness to buy self-test constituted the outcome for HIVST effectiveness. Results. The rate of successful performance of the test was same (93.2%) in UH and DAH. The rate of correct interpretation of the results was 86.9% in UH versus 93.2% in DAH yielding the difference of -6.3% (95% CI: -10.8 to 2.5). UH significantly decreased the rate of correct interpretation of results as compared to DAH (aRR: 0.60 [95% CI: 0.36 to 0.98]; P=0.019). None significant difference was found between two arms in evaluating the linkage to care. Willingness to buy HIV self-test was higher in UH as compared to DAH (92.3% versus 74.1%; aRR: 4.20 [95% CI: 2.42 to 7.32]; P<0.001). Conclusion. This study demonstrates that both UH and DAH show high level of practicability and effectiveness for HIVST. However, additional support tools will be need to improve the practicability of the test in UH. Taken together, UH as well as DAH should improve access to HIV testing in DRC. Trial registration: PACTR201904546865585. Registered 03 April 2019 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=6032

Sociodemographic characteristics of adolescents preferring home-based HIV self-testing over facility-based voluntary counseling and testing: a cross-sectional study in Kisangani, Democratic Republic of the Congo

2020 ◽  
Vol 31 (5) ◽  
pp. 481-487 ◽  
Author(s):  
Serge Tonen-Wolyec ◽  
Ralph-Sydney Mboumba Bouassa ◽  
Salomon Batina-Agasa ◽  
Alliance Tagoto Tepungipame ◽  
Charles Kayembe Tshilumba ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Voluntary Counseling And Testing ◽  
Counseling And Testing ◽  
Home Based ◽  
Self Testing ◽  
Republic Of The Congo ◽  
Study Questionnaire

HIV self-testing (HIVST) offers an alternative to facility-based voluntary counseling and testing (VCT) services, particularly for vulnerable populations such as adolescents. This study aimed to determine the sociodemographic factors associated with adolescents preferring home-based HIVST over facility-based VCT in Kisangani, Democratic Republic of the Congo. A representative cross-sectional study using random sampling in clusters at three levels was conducted among adolescents (aged 15–19 years) to assess their hypothetical preference in home-based HIVST over facility-based VCT by a face-to-face, paper-based, semi-structured questionnaire, and logistic regression for statistical analysis. In 353 households, 754 adolescents were assessed for eligibility, of whom 628 were eligible. A total of 597 adolescents completed the study questionnaire. A majority of participants were aged 18–19 and of female gender. More than two-thirds of participants had never been tested for HIV and had no knowledge about HIVST before this survey. Among 597 adolescents who had completed the study questionnaire, a slight majority of participants (323/597; 54.1% [95% CI: 50.0–58.0]) preferred home-based HIVST over facility-based VCT. In a multivariate analysis, male gender (adjusted OR: 1.5, 95% CI: 1.1–2.1), marriage or partnered civil status (adjusted OR: 1.8, 95% CI: 1.1–3.1), and previous knowledge about HIVST (adjusted OR: 4.2, 95% CI: 2.6–6.8) were associated with preference for home-based HIVST over facility-based VCT. This study demonstrates that more adolescents preferred home-based HIVST over facility-based VCT in Kisangani. These observations suggest the existence of a specific sociodemographic profile associated with the acceptance of HIVST in adolescents living in sub-Saharan Africa.

scholarly journals Comparison of practicability and effectiveness between unassisted HIV self-testing and directly assisted HIV self-testing in the Democratic Republic of the Congo: a randomized feasibility trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Serge Tonen-Wolyec ◽  
Charles Kayembe Tshilumba ◽  
Salomon Batina-Agasa ◽  
Roland Marini Djang’eing’a ◽  
Marie-Pierre Hayette ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Democratic Republic ◽  
Linkage To Care ◽  
Feasibility Trial ◽  
Test Results ◽  
Self Testing ◽  
Willingness To Buy ◽  
Republic Of The Congo ◽  
Self Test

Abstract Background HIV self-testing (HIVST) can be performed using directly assisted and unassisted approaches in facilities or communities to reach different populations. The aim of this study was to compare the practicability and effectiveness of the two delivery approaches for HIVST, unassisted HIVST (UH) and directly assisted HIVST (DAH), in the field setting of Kisangani, the Democratic Republic of the Congo (DRC). Methods A randomized (1:1), non-blinded, non-inferiority trial using a blood-based and facility-based HIVST method was carried out in four facilities in Kisangani, the DRC, targeting populations at high risk for HIV infection. The primary outcome was the difference in the practicability of the HIV self-test between the two arms. Practicability was defined as successfully performing the test and correctly interpreting the result. Requests for assistance, positivity rate, linkage to care, and willingness to buy an HIV self-test kit constituted the secondary outcomes for HIVST effectiveness. The adjusted risk ratios (aRRs) were calculated using Poisson regression. Results The rate of successfully performing the test was same (93.2%) in the UH and DAH arms. The rate of correctly interpreting the results was 86.9% in the UH arm versus 93.2% in the DAH arm, for a difference of − 6.3%. After the follow-up 72 h later, participants in the UH arm had a significantly lower chance of correctly interpreting the test results than those in the DAH arm (aRR: 0.60; P = 0.019). Although the positivity rate was 3.4% among the participants in the DAH arm and 1.7% among those in the UH arm, no significant differences were found between the two arms in the positivity rate, requests for assistance, and linkage to care. Willingness to buy an HIV self-test was higher in the UH arm than in the DAH arm (92.3% versus 74.1%; aRR: 4.20; P < 0.001). Conclusion The results of this study indicate that UH is as practicable and effective as DAH among individuals at high risk for HIV infection in Kisangani, the DRC. However, additional support tools need to be assessed to improve the interpretation of the self-test results when using the UH approach. Trial registration PACTR201904546865585. Registered 03 April 2019 - Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=6032

scholarly journals Uptake of HIV/AIDS Services Following a Positive Self-Test Is Lower in Men Than Women in the Democratic Republic of the Congo

2021 ◽  
Vol 8 ◽  
Author(s):  
Serge Tonen-Wolyec ◽  
Charles Kayembe Tshilumba ◽  
Salomon Batina-Agasa ◽  
Alliance Tagoto Tepungipame ◽  
Laurent Bélec
Keyword(s):  
Positive Result ◽  
Democratic Republic ◽  
Secondary Analysis ◽  
Linkage To Care ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Self Testing ◽  
Republic Of The Congo ◽  
Self Test ◽  
Linkage To Hiv Care

As far as HIV self-testing (HIVST) is concerned, proving the link to HIV care for users with a positive result contributes to understanding the implementation of HIVST. We sought to examine whether there were differences by sex in the uptake of HIV services following a positive self-test in the Democratic Republic of the Congo (DRC). This was a mixed-methods study exploring linkage to care for HIVST through a secondary analysis of collected data from three pilot surveys recently conducted in three cities (Kinshasa, Kisangani, and Kindu) during 2018 and 2020 in the DRC. Linkage to HIV care was defined as delayed when observed beyond 1 week. A total of 1,652 individuals were self-tested for HIV. Overall, the proportion of linkage to HIV care was high (n = 258; 82.2%) among individuals having a positive result with HIV self-test (n = 314), but it was significantly lower in men (65.2%) than women (89.2%). Furthermore, linkage to HIV care of men was significantly delayed as compared with that of women (40.0 vs. 20.7%). These findings show a lower uptake of care following a positive self-test in men than women. This trend already previously observed in sub-Saharan Africa shed light on the need to increase linkages to care among men newly diagnosed through HIV self-testing.

scholarly journals Revisiting Konzo Risk Factors in Three Areas Differently Affected by Spastic Paraparesis in Eastern Democratic Republic of the Congo Discloses a Prominent Role of the Nutritional Status—A Comparative Cross-Sectional Study

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2628
Author(s):  
Marius Baguma ◽  
Espoir Bwenge Malembaka ◽  
Esto Bahizire ◽  
Germain Zabaday Mudumbi ◽  
Dieudonné Bahati Shamamba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nutritional Status ◽  
Democratic Republic ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cyanide Poisoning ◽  
Cross Sectional ◽  
High Prevalence ◽  
Republic Of The Congo

This comparative cross-sectional study aimed to better understand the respective contributions of protein malnutrition and cassava-derived cyanide poisoning in the development of konzo. We compared data on nutritional status and cyanide exposure of school-age adolescent konzo-diseased patients to those of non-konzo subjects of similar age from three areas in the Eastern Democratic Republic of the Congo. Our results show that konzo patients had a high prevalence of both wasting (54.5%) and stunting (72.7%), as well as of cyanide poisoning (81.8%). Controls from Burhinyi and those from Idjwi showed a similar profile with a low prevalence of wasting (3.3% and 6.5%, respectively) and intermediate prevalence of stunting (26.7% and 23.9%, respectively). They both had a high prevalence of cyanide poisoning (50.0% and 63.0%, respectively), similar to konzo-patients. On the other hand, controls from Bukavu showed the lowest prevalence of both risk factors, namely chronic malnutrition (12.1%) and cyanide poisoning (27.6%). In conclusion, cassava-derived cyanide poisoning does not necessarily coexist with konzo outbreaks. The only factor differentiating konzo patients from healthy individuals exposed to cyanide poisoning appeared to be their worse nutritional status. This further suggests that, besides the known role of cyanide poisoning in the pathogenesis of konzo, malnutrition may be a key factor for the disease occurrence.

Feasibility of Indirect Secondary Distribution of HIV Self-Test Kits via WeChat Among Men Who Have Sex with Men: A National Cross-Sectional Study in China (Preprint)

2021 ◽  
Author(s):  
Li Shangcao ◽  
Jing Zhang ◽  
Xiang Mao ◽  
Tianyi Lu ◽  
Yangyang Gao ◽  
...  
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Sexual Partners ◽  
Cross Sectional ◽  
Self Testing ◽  
Hiv Test ◽  
Condomless Anal Intercourse ◽  
Secondary Distribution ◽  
Self Test ◽  
Sex With Men

BACKGROUND The use of HIV self-test (HST) kits is commonplace in key sexually active populations. The direct secondary distribution of HST kits (DSDHK) is effective in improving the uptake of HIV self-testing. However, there are concerns about various limitations of DSDHK, including limited geographic location, payment problems, and face-to-face interaction. OBJECTIVE We evaluated the feasibility and characteristics of the indirect secondary distribution of HST kits (ISDHK) via WeChat (distributing HST application links and follow-up HST kits to partners) among men who have sex with men (MSM). METHODS From October 2017 to September 2019, an HIV self-testing (HIVST) recruitment advertisement was disseminated on the WeChat social media platform to invite MSM to apply for HST kits (referred to as “index participants” [Ips]). All of the MSM participants were encouraged to distribute the HST application link to their friends and sexual partners (referred to as “Alters”) through their social networks. All Alters were further encouraged to continue to distribute the HST application link. All participants paid a deposit (USD 7), refundable upon completion of the questionnaire and uploading of the test result via an online survey system. RESULTS 2,263 MSM met the criteria and successfully applied for HST. Of these, 1,816 participants returned their HST test results, including 1,422 (88.3%) IPs and 394 (21.7%) Alters. Compared with the IPs, the Alters practiced more condomless anal intercourse (CAI), a higher proportion of them never previously had an HIV test, and they had a greater willingness to distribute HST kits to sexual partners (all p < 0.05). After controlling for age, education, and income, the Alters had a greater proportion of MSM who had never tested for HIV before (aOR = 1.29, 95% CI 1.00–1.68), were more willing to distribute the HST application link (aOR = 1.71, 95% CI 1.21–2.40), had a lower number of sexual partners (aOR = 0.71, 95% CI 0.57–0.90), and were less likely to search for sexual partners via online means (aOR = 0.78, 95% CI 0.60–1.02). In comparison, the rates of reactive HST results, conducting HIV confirmatory tests, HIV seropositivity, and initiation of HIV antiretroviral therapy (ART) were similar for IPs and Alters. CONCLUSIONS The ISDHK mode of distributing HST application links via social media is feasible among the MSM population. The ISDHK mode should be used to supplement the DSDHK mode in order to enable a greater proportion of the MSM population to know their HIV infection status.

scholarly journals The effect of gender norms on the association between violence and hope among girls in the Democratic Republic of the Congo

2017 ◽  
Vol 4 ◽  
Author(s):  
L. Stark ◽  
K. Asghar ◽  
S. Meyer ◽  
G. Yu ◽  
T. Bakemore ◽  
...  
Keyword(s):  
Sexual Violence ◽  
Partner Violence ◽  
Violence Exposure ◽  
Democratic Republic ◽  
Physical Violence ◽  
Future Orientation ◽  
Gender Norms ◽  
Exposure To Violence ◽  
Cross Sectional ◽  
Republic Of The Congo

Background.Girls at early stages of adolescence are vulnerable to violence victimization in humanitarian contexts, but few studies examine factors that affect girls’ hope in these settings. We assessed attitudes toward traditional gender norms as an effect modifier of the relationship between violence exposure and future orientation in displaced girls.Methods.Secondary analysis, using multivariable regression of cross-sectional data from girls ages 10–14 in South Kivu, Democratic Republic of the Congo. Key variables of interest were attitudes toward intimate partner violence (IPV), Children's Hope Scale (CHS) score, and exposure to physical, emotional, and sexual violence within the last 12 months. Additional covariates included age, educational status, and territory.Results.The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for physical violence (β = −0.09, p = 0.040) and unwanted sexual touching (β = −0.20, p = 0.003) among girls age 10–14, when adjusting for other covariates. The interaction of exposure to violence and attitudes toward IPV magnified the association between violence exposure and lower CHS score for forced sex (β = −0.22, p = 0.016) among girls age 13–14, when adjusting for covariates. Findings for emotional violence, any form of sexual violence, and coerced sex trended toward lower CHS scores for girls who reported higher acceptance of IPV, but did not reach significance.Conclusions.Findings support the utility of gender norms-transformative programming in increasing resilience of girls who have experienced sexual violence in humanitarian contexts.

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