Usability of three finger-stick whole blood HIV self-testing kits among men who have sex with men and female sex workers in Yaounde and Douala, Cameroon

Abstract Background The use of fingerstick whole-blood HIV self-testing (HIVST) represents a novel approach to improving HIV screening, particularly among at-risk populations. However, there is currently a paucity of empirical evidence on its usability in Cameroon, necessitating the development of robust empirical evidence before this approach can be scaled up. This study assessed the usability of three HIVST kits among men who have sex with men (MSM) and female sex workers (FSWs) in Cameroon. Materials and Methods A study was conducted between 11 June and 22 June 2022 at 14 community-based organisations in Yaoundé and Douala. The study involved FSWs and MSM aged 21 and over. The participants were provided with counselling, unassisted finger-stick whole blood HIVST, and condoms. Data were collected using a questionnaire and three HIVST kits: Mylan, Sure Check, and Check Now. The analysis was conducted using SPSS 27 software. Results Of the 815 participants who completed the HIV blood self-test, the median age was 27 years and 56.1% were FSWs. One in ten participants had never undergone an HIV test. The successful test performance for the Check Now, Sure Check and Mylan tests were 98.5%, 97.8% and 94.7%, respectively. In addition, the proportions of correct interpretation of results were 83.1%, 79.3% and 79.8%. The agreement between a participant's blood-based HIV self-test result and those of trained investigator-observers results was moderate with Check Now (κ=0.486; 95% CI: 0.366-0.605; p=0.001), whereas agreement with Sure Check (κ=0.36) and Mylan (κ=0.372) was low. Similarly, the proportions of good usability were 82.0%, 77.9% and 75.3 respectively. On multivariate analysis, participants who had difficulty drawing blood with the micropipette were more likely to fail the self-test (aOR=0.1; 95% CI: 0.0-0.3; P = 0.005). Conclusion In Cameroon, key populations are utilising fingerstick whole blood HIV self-testing kits for HIV testing purposes. However, issues have been identified with regard to interpretation, thereby underscoring the necessity for further training in order to enhance the accuracy of these tests and optimise the effectiveness of HIV prevention interventions.