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. 2024 Oct 24;19(10):e0312693.
doi: 10.1371/journal.pone.0312693. eCollection 2024.

HIV self-testing: A highly acceptable and feasible strategy for reconnecting street adolescents with HIV screening and prevention services in Togo (The STADOS study)

Arnold Junior Sadio  1   2   3 , Harold Régis Kouanfack  2 , Rodion Yao Konu  1   2   3 , Fifonsi Adjidossi Gbeasor-Komlanvi  1   2 , Gagnon Kwami Azialey  4 , Herbert Kokou Gounon  1   2 , Martin Kouame Tchankoni  1   2 , Amivi Phyllis Amenyah-Ehlan  5 , Anoumou Claver Dagnra  5   6 , Didier Koumavi Ekouevi  1   2   3
Affiliations

HIV self-testing: A highly acceptable and feasible strategy for reconnecting street adolescents with HIV screening and prevention services in Togo (The STADOS study)

Arnold Junior Sadio et al. PLoS One. .

Abstract

Introduction: HIV self-testing is a complementary screening strategy that could facilitate access to HIV care services for street adolescents. The objectives of this study were to assess the acceptability and feasibility of HIV self-testing and their associated factors, to estimate HIV prevalence among street adolescents in Togo, and to describe the sexual behavior of this population.

Methods: A cross-sectional study was conducted between July 2021 and May 2022 in Lomé and Kara (Togolese cities with the highest number of street adolescents). Street adolescents aged 13-19 years were included. An oral HIV self-test (OraQuick®) was used. Acceptability was defined as the proportion of adolescents who completed the test, and feasibility was defined as the proportion of adolescents who reported a test with a valid result. An HIV serological test was performed for all participants. A weighted logistic regression model was used to identify the factors associated with the acceptability and feasibility of HIV self-testing.

Results: A total of 432 street adolescents (12.3% female) with a median age of 15 years, interquartile range (IQR) [14-17], were included in this study. Of the 231 sexually active adolescents, only 30.3% (n = 70) reported having used a condom during their last sexual intercourse. HIV self-test was offered to a sub-sample of 294 street adolescents. Acceptability was 96.6% (284/294), (95%CI = [93.8-98.3]) and feasibility 98.9% (281/284), (95%CI = [97.0-100.0]). Being 16 years of age or older (aOR = 28.84; p<0.001) was associated with HIV self-test acceptability. Reporting drug abuse (aOR = 0.47; p = 0.020) was negatively associated to acceptability. Having an educational level at least equivalent to secondary school was associated to HIV self-testing feasibility (aOR = 3.92; p = 0.040). Self-test results were correctly interpreted by 98.6% of street adolescents. HIV prevalence was estimated at 0.9% (95%CI [0.4-2.4]).

Conclusion: HIV self-testing is acceptable and feasible among street adolescents, a population at high risk of HIV infection in Togo. The provision of HIV self-testing kits, coupled with condom distribution, represents an opportunity to improve access to HIV care services.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart showing the inclusion process.
Fig 1 shows the flow chart and the different interventions proposed at each stage of the enrolment process.
Fig 2
Fig 2. Factor associated to acceptability of HIV self-testing among street adolescents, Togo, 2021.
Fig 2 presents the results of a multivariable regression model as a forest plot showing the factors associated or not with acceptability, with their adjusted odds ratios.
Fig 3
Fig 3. Factor associated to feasibility of HIV self-testing among street adolescents, Togo, 2021.
Fig 3 presents the results of a multivariable regression model as a forest plot showing the factors associated or not with feasibility, with their adjusted odds ratios.
See this image and copyright information in PMC

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