{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:51:07Z","timestamp":1791805867836,"version":"4.3.4"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["Cooperative agreements #NU2GGH001943 and #NU2GGH002367"],"award-info":[{"award-number":["Cooperative agreements #NU2GGH001943 and #NU2GGH002367"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In 2021, Mozambique initiated community-based oral HIV self-testing (HIVST) to increase testing access and uptake among priority groups, including adult males, adolescents, and young adults. Within an HIVST pilot project, we conducted a performance evaluation assessing participants\u2019 ability to successfully conduct HIVST procedures and interpret results.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional study was performed between February-March 2021 among employees, students (18\u201324 years of age), and community members, using convenience sampling, in two rural districts of Zamb\u00e9zia Province, Mozambique. We quantified how well untrained users performed procedures for the oral HIVST (Oraquick<jats:sup>\u00ae<\/jats:sup>) through direct observation using a structured checklist, from which we calculated an HIVST usability index (scores ranging 0\u2013100%). Additionally, participants interpreted three previously processed anonymous HIVST results. False reactive and false non-reactive interpretation results were presented as proportions. Bivariate analysis was conducted using Chi-square and Fisher exact tests.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 312 persons participated (131[42%] community members, 71[23%] students, 110[35%] employees); 239 (77%) were male; the mean age was 28 years (standard deviation 10). Average usability index scores were 80% among employees, 86% among students, and 77% among community members. Main procedural errors observed included \u201cincorrect tube positioning\u201d (49%), \u201cincorrect specimen collection\u201d (43%), and \u201cimproper waiting time for result interpretation\u201d (42%). From the presented anonymous HIVST results, 75% (n = 234) correctly interpreted all three results, while 9 (3%) of study participants failed to correctly interpret any results. Overall, 36 (12%) gave a false non-reactive result interpretation, 21 (7%) a false reactive result interpretation, and 14 (4%) gave both false non-reactive and false reactive result interpretations. Community members generally had lower performance.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Despite some observed testing procedural errors, most users could successfully perform an HIVST. Educational sessions at strategic places (<jats:italic>e<\/jats:italic>.<jats:italic>g<\/jats:italic>., schools, workplaces), and support via social media and hotlines, may improve HIVST performance quality, reducing the risk of incorrect interpretation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0305391","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T17:32:43Z","timestamp":1718645563000},"page":"e0305391","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["HIV self-test performance evaluation among priority populations in rural Mozambique: Results from a community-based observational study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5384-2410","authenticated-orcid":true,"given":"Caroline","family":"De Schacht","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlota","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Paulo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anibal","family":"Naftal Fernando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalilo","family":"Ernesto Chinai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson P.","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guita","family":"Amane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thebora","family":"Sultane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nely","family":"Honwana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inacio","family":"Malimane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleny","family":"Couto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihong","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. William","family":"Wester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,6,17]]},"reference":[{"key":"pone.0305391.ref001","unstructured":"WHO. Guidelines on HIV self-testing and partner notification. Supplement to consolidated guidelines on HIV testing services. December 2016 Geneva: WHO; 2016 [https:\/\/apps.who.int\/iris\/handle\/10665\/251655."},{"key":"pone.0305391.ref002","unstructured":"WHO. WHO recommends HIV self-testing\u2014evidence update and considerations for success Geneva: WHO; 2019 [https:\/\/www.who.int\/publications\/i\/item\/WHO-CDS-HIV-19.36."},{"issue":"4","key":"pone.0305391.ref003","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1007\/s10461-015-1213-9","article-title":"Accuracy and Acceptability of Oral Fluid HIV Self-Testing in a General Adult Population in Kenya","volume":"20","author":"AE Kurth","year":"2016","journal-title":"AIDS Behav"},{"issue":"3","key":"pone.0305391.ref004","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1089\/aid.2017.0156","article-title":"HIV Self-Testing in Lusaka Province, Zambia: Acceptability, Comprehension of Testing Instructions, and Individual Preferences for Self-Test Kit Distribution in a Population-Based Sample of Adolescents and Adults","volume":"34","author":"A Zanolini","year":"2018","journal-title":"AIDS Res Hum Retroviruses"},{"issue":"1","key":"pone.0305391.ref005","doi-asserted-by":"crossref","first-page":"e0227198","DOI":"10.1371\/journal.pone.0227198","article-title":"Usability assessment of seven HIV self-test devices conducted with lay-users in Johannesburg, South Africa","volume":"15","author":"M Majam","year":"2020","journal-title":"PLoS One"},{"issue":"4","key":"pone.0305391.ref006","doi-asserted-by":"crossref","first-page":"e0215353","DOI":"10.1371\/journal.pone.0215353","article-title":"Feasibility and robustness of an oral HIV self-test in a rural community in South-Africa: An observational diagnostic study","volume":"14","author":"W Deville","year":"2019","journal-title":"PLoS One"},{"issue":"3","key":"pone.0305391.ref007","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1136\/sextrans-2017-053231","article-title":"Prospective observational study to evaluate the performance of the BioSure HIV Self-Test in the hands of lay users","volume":"94","author":"J Saunders","year":"2018","journal-title":"Sex Transm Infect"},{"issue":"11","key":"pone.0305391.ref008","doi-asserted-by":"crossref","first-page":"e022652","DOI":"10.1136\/bmjopen-2018-022652","article-title":"HIV self-test performance among female sex workers in Kampala, Uganda: a cross-sectional study","volume":"8","author":"KF Ortblad","year":"2018","journal-title":"BMJ Open"},{"key":"pone.0305391.ref009","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/S1473-3099(11)70368-1","article-title":"Head-to-head comparison of accuracy of a rapid point-of-care HIV test with oral versus whole-blood specimens: a systematic review and meta-analysis","volume":"12","author":"N Pant Pai","year":"2012","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"pone.0305391.ref010","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1136\/sextrans-2011-050131","article-title":"Supervised blood-based self-sample collection and rapid test performance: a valuable alternative to the use of saliva by HIV testing programmes with no medical or nursing staff","volume":"88","author":"MJ Belza","year":"2012","journal-title":"Sex Transm Infect"},{"issue":"10","key":"pone.0305391.ref011","doi-asserted-by":"crossref","first-page":"e0239607","DOI":"10.1371\/journal.pone.0239607","article-title":"Field evaluation of capillary blood and oral-fluid HIV self-tests in the Democratic Republic of the Congo","volume":"15","author":"S Tonen-Wolyec","year":"2020","journal-title":"PLoS One"},{"key":"pone.0305391.ref012","unstructured":"INS. Mozambique\u2014Population-based HIV Impact Assessment. INSIDA 2021 Maputo2022 [https:\/\/ins.gov.mz\/divulgados-resultados-do-inquerito-sobre-o-impacto-do-hiv-e-sida-em-mocambique\/."},{"key":"pone.0305391.ref013","unstructured":"INS, INE, ICF. Inqu\u00e9rito de Indicadores de Imuniza\u00e7\u00e3o, Mal\u00e1ria e HIV\/SIDA Em Mo\u00e7ambique 2015. Relat\u00f3rio Preliminar de Indicadores de HIV. 2015 [http:\/\/www.ins.gov.mz\/images\/IMASIDA\/IMASIDA"},{"issue":"8","key":"pone.0305391.ref014","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1089\/aid.2021.0116","article-title":"Reaching Men and Young Adults in a Pharmacy-Based HIV Self-Testing Strategy: Results from an Acceptability Study in Mozambique","volume":"38","author":"C De Schacht","year":"2022","journal-title":"AIDS Res Hum Retroviruses"},{"key":"pone.0305391.ref015","unstructured":"MOH. 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R Foundation for Statistical Computing Vienna, Austria2022 [https:\/\/www.R-project.org\/."},{"issue":"10","key":"pone.0305391.ref021","article-title":"Assessment of the Sedia HIV Self-Test Device: Usability and Performance in the Hands of Untrained Users in Johannesburg, South Africa","volume":"11","author":"M Majam","year":"2021","journal-title":"Diagnostics (Basel)"},{"issue":"11","key":"pone.0305391.ref022","doi-asserted-by":"crossref","first-page":"e0206849","DOI":"10.1371\/journal.pone.0206849","article-title":"Ability to use oral fluid and fingerstick HIV self-testing (HIVST) among South African MSM","volume":"13","author":"SA Lippman","year":"2018","journal-title":"PLoS One"},{"key":"pone.0305391.ref023","unstructured":"MOH. Gui\u00e3o de Cuidados de HIV do Adulto, Adolescente Gr\u00e1vida, Lactante e Crian\u00e7a 2023 [https:\/\/comitetarvmisau.co.mz\/docs\/guiao_tarv\/Tratamento%20antiretroviral%20e%20infecc%CC%A7o%CC%83es%20oportunistas%20do%20adulto,%20adolescente%20e%20crianc%CC%A7a_27.03.2023.pdf."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T17:33:00Z","timestamp":1718645580000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0305391"}},"subtitle":[],"editor":[{"given":"Delfina Fernandes","family":"Hlashwayo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,6,17]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0305391","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,17]]}}}