PROSPERO International prospective register of systematic reviews
A systematic review of the feasibility and acceptability of self-sampling for HIV testing, and the effectiveness of HIV self-sampling in increasing the uptake of HIV testing
Fiona Burns, Ibi Fakoye, Lisa McDaid, Sonali Wayal, Gemma Phillips, Esther Mugweni, Thomas Hartney
Fiona Burns, Ibi Fakoye, Lisa McDaid, Sonali Wayal, Gemma Phillips, Esther Mugweni, Thomas Hartney. A systematic review of the feasibility and acceptability of self-sampling for HIV testing, and the effectiveness of HIV self-sampling in increasing the uptake of HIV testing.
Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014010698
Our review will look at studies on HIV self-sampling and self-testing - their utility, uptake, barriers, implementation, feasibility and acceptability.
We aim to improve the provision, acceptability and uptake of HIV testing by developing an HIV self-sampling kit distribution interventions within existing health care and community services. Intervention development will be informed by literature review and extensive qualitative work. We will then test the feasibility of the interventions within a Phase II study, and if successful manualise the interventions.
Peer-review articles will be located using the following computerised databases: OvidSP MEDLINE; OvidSP Embase Classic+Embase; OvidSP Global Health; OvidSP Social Policy and Practice; OvidSP PsycINFO; Ovid SP HMIC Health Management Information Consortium; EBSCO CINAHL Plus with Full Text; Cochrane Library; Web of Science™ Core Collection; SCOPUS
The initial search was undertaken on 26 September 2014. Two further searches to update the database were undertaken 17 April 2015 on and 3 May 2016. Additional grey literature was retrieved from websites operated by the following organisations:
• Avert (www.avert.org)
• Terrence Higgins Trust (www.tht.org.uk)
• National AIDS Trust (www.nat.org.uk)
• Lambeth Council (http://www.lambeth.gov.uk/consultations/lambeth-southwark-lewisham-sexual-health-strategy-consultation)
• Naz Project London (http://naz.org.uk)
• Sexual Health Sheffield (http://www.sexualhealthsheffield.nhs.uk)
Only studies published since 1st January 2000 were included.
Types of study to be included
Types of studies
Study designs considered for inclusion:
• Randomised or non-randomised controlled trials
• Prospective or retrospective cohorts
• Cross sectional studies / prevalence studies
• Pilots or feasibility studies
• Qualitative studies (using in-depth interviews, focus group discussions, and document analysis)
Condition or domain being studied
Only studies conducted in the European Union/European Free Trade Agreement countries, North America, New Zealand or Australia were included as studies conducted in other locations, (particularly resource poor settings) would likely have markedly different results that would not be applicable in the United Kingdom. Study populations that included lay groups as well as health professionals were included.
Interventions and comparators
Only studies that examined home/self-sampling for HIV were included as intervention studies.
Only studies published since 1st January 2000 were included since it was thought that studies published earlier would be unlikely to reflect current technology or attitudes to HIV testing.
Studies that examined the use of or views about self-sampling for HIV in healthcare workers were excluded as were all conference communications. Studies that focussed solely on, or whose outcomes were predominantly about, home testing for HIV were also excluded at the study selection stage.
Studies without comparators were also included as well as studies that compared home/self-sampling for HIV with routine service provision or other HIV testing interventions.
Studies were included if they reported on any of the following outcomes:
• Increase / decrease in number of HIV tests
• Proportion /number of confirmatory tests
• Proportion /number of participants linked into care
• Adverse events associated with HIV self-sampling
• Proportion/number of false positives or failed tests
• Increase / decrease in the reported history and frequency of taking HIV tests
• Increase / decrease in the number and types of venue where HIV testing is offered
Qualitative studies only:
• Barriers or facilitator to self-sampling reported by general population
• Barriers or facilitators to self-sampling reported by providers
Data extraction, (selection and coding)
Studies were selected using a two stage screening approach, involving two researchers, who independently screened titles and abstracts and then full paper copies. Where a consensus could not be reached about study inclusion a third reviewer was used.
Structured data extraction tools were developed to capture the required information from the included papers on study types, populations, SSK interventions, and acceptability, feasibility and efficacy outcomes. Data were extracted by one reviewer and checked by another.
Risk of bias (quality) assessment
Quality of the eligible papers were appraised using the NICE quality appraisal.
Strategy for data synthesis
A narrative approach was used to analyse and synthesise the data.
Analysis of subgroups or subsets
Review included as a chapter in the NIHR Final Report.
Contact details for further information
UCL Department of Infection and Population Health,
Address: Mortimer Market Centre, off Capper Street, London WC1E 6JB
Organisational affiliation of the review
University College London Research Department of Infection and Population Health
Dr Fiona Burns, UCL Ms Ibi Fakoye, UCL Dr Lisa McDaid, University of Glasgow Ms Sonali Wayal, UCL Dr Gemma Phillips, University of Glasgow Dr Esther Mugweni, UCL Mr Thomas Hartney, UCL
Anticipated or actual start date
01 August 2014
Anticipated completion date
21 October 2016
NIHR HTA - Project: 12/138/02
Conflicts of interest
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
African Continental Ancestry Group; Great Britain; HIV; HIV Infections; Humans; Mass Screening; Specimen Handling
Stage of review
Completed but not published
Date of registration in PROSPERO
16 July 2014
Date of publication of this revision
28 October 2016
Stage of review at time of this submission
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Risk of bias (quality) assessment
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.