%0 Journal Article
%T Acceptability, usability, and willingness to pay for HIV self-test kits distributed through community-based, PLHIV network-led and private practitioners models in India: Results from the STAR III Initiative.
%A Laxmeshwar C
%A Hegde A
%A Dange A
%A Mariyappan K
%A Soosai M
%A Mane S
%A Sivasubramanian M
%A Doddamane M
%A Mukherjee M
%A Shreenivas GS
%A Pardesi M
%A Jambhale V
%A Rao Pakkela V
%A Arumugam V
%A Rungta V
%A Bansal Y
%A Chaudary J
%A Yeldandi V
%A Periasamy M
%A Uthappa C
%A Chawla S
%A Upadhyaya S
%A Nyendak M
%A Chakrapani V
%A Godbole S
%A Verma V
%A Singh Kushwaha B
%A Das C
%A Rajan S
%A Kumar Puri A
%A Prasada Rao JVR
%A Bhatnagar T
%A Reddy DCS
%A Green K
%J J Int AIDS Soc
%V 27
%N 8
%D 2024 Aug
%M 39118294
%F 6.707
%R 10.1002/jia2.26348
%X <B>BACKGROUND: </B>HIV self-testing (HIVST) has been shown to increase the uptake of HIV testing and help achieve the UNAIDS 95-95-95 targets. This study assessed the acceptability, usability (ease of use and result interpretation) and the willingness to pay for HIVST kits distributed through three distribution models, namely the community-based, PLHIV network-led and private practitioners models, in India.<BR><B>METHODS: </B>This cross-sectional study was implemented across 14 states in India between September 2021 and June 2022. All participants could choose between blood-based or oral-fluid-based test kits. Participants were shown a test-kit usage demonstration video, and pre- and post-test counselling was provided for all. Participants were followed-up after testing, and if reported reactive, were further supported for linkage to confirmatory testing and antiretroviral therapy (ART) initiation.<BR><B>RESULTS: </B>Among the 90,605 participants found eligible, 88,080 (97%) accepted an HIVST kit. Among the 87,976 who reported using an HIVST kit, 45,207 (51%) preferred a blood-based kit, and 42,120 (48%) reported testing for the first time. For future testing, 77,064 (88%) reported preferring HIVST over other HIV testing methods. Among those who used the kit, 83,308 (95%) found the kit easy to use, and 83,237 (95%) reported that the test results were easy to interpret. Among those who preferred HIVST for future use, 52,136 (69%) were willing to pay for the kit, with 35,854 (69%) of those willing to pay less than US$ 1.20. Only one instance of social harm was reported, with a participant reporting suicidal tendencies due to discord with their partner. Out of 328 participants (0.4%) who tested reactive with HIVST, 291 (89%) were linked to confirmatory testing; of these, 254 were confirmed HIV positive, and 216 (85%) successfully initiated ART.<BR><B>CONCLUSIONS: </B>Overall, we report that nearly all participants were willing to accept HIVST, found the test kits easy to use and interpret, and about two-thirds were willing to pay for HIVST. Given the high levels of acceptance and the ability to reach a large proportion of first-time testers, HIVST in India could contribute to achieving the UNAIDS first 95 and ending the HIV epidemic.