Evaluating the Feasibility and Usability of Blood-based Abbott CheckNOW™ HIV SELF TEST among Men Who Have Sex with Men and Transgender Women in KwaZulu-Natal, South Africa: A Cross-Sectional Study

Key populations, particularly men who have sex with men and transgender women, face significant challenges in accessing HIV testing services in public health facilities, despite their availability. Lack or avoidance of HIV testing among these populations results in delayed diagnosis and increased HIV transmission risk. HIVST has emerged as a potential approach to increasing HIV testing uptake. This study evaluated the usability, feasibility, and acceptability of the CheckNOW™ HIV SELF TEST kit to inform public health strategies and policies aimed at enhancing HIV testing and linkage to care among these vulnerable populations.

A cross-sectional study using convenience sampling was conducted between February and April 2024 in two Kwa-Zulu Natal districts in South Africa. A sample of 250 men who have sex with men and transgender women aged 18 years of age and above was included in the study. Data were collected through a paper-based questionnaire exploring the feasibility and usability of the blood-based CheckNOW HIV Self-Test. Completed questionnaires were digitised into Epicollect. Data were analyzed using SPSS Version 29, employing descriptive statistics to assess overall usability and feasibility, and Cohen’s coefficient of agreement to evaluate concordance between staff and participant test interpretations. Error occurrences were categorized as critical or non-critical to assess operational challenges.

Of the 245 participants who completed the test, 89.3% (CI: 85.2-92.6%) found it easy to carry out the whole test, and 91.7% (CI: 87.7-94.7%) rated the test as acceptable. Additionally, 40.8% (CI: 34.8-47.1%) of participants were able to draw blood from the basin without generating bubbles, while 76.6% (CI: 71.7-82.6%) of participants found it easy to collect enough blood. Discussion: The study reported high usability and feasibility scores for the test; however, this evaluation revealed broader perspectives that offer room for improvement. This was achieved through the survey design, which investigated and identified points of confusion or hesitation, as well as any critical and non-critical errors made during the self-testing procedure.

The study findings support the notion that HIVST is highly usable, feasible, and acceptable, therefore informing its scale-up to help address a critical gap in the HIV prevention and treatment efforts among these key populations.