Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: a randomized controlled trial

Figures & data

Figure 1. Flow of study participants (Consort Flowchart).

Table 1. Descriptive statistics for the sample overall and by randomization arm.

Variable	Total, n (Column %)	SOC Arm, n (Row %)	Choice Arm, n (Row %)	P-value chi-square test, unless otherwise specified
Total	305	155 (50.8%)	150 (49.2%)	NA
Clinic where recruited				0.787
Clinic 1	144 (47.2%)	72 (46.5%)	72 (48.0%)
Clinic 2	161 (52.8%)	83 (53.5%)	78 (52.0%)
Age in years				0.989^a
Mean (SD)	37.0 (7.9)	36.9 (8.0)	37.2 (7.8)
Median (range)	36.0 (21.0–62.0)	35.0 (21.0–60.0)	37.0 (24.0–62.0)
High school graduate				0.417
No	196 (64.3%)	103 (66.5%)	93 (62.0%)
Yes	109 (35.7%)	52 (33.5%)	57 (38.0%)
Mean trucking income per month (Kenyan Shillings)				0.074
8,000–15,999 KES	15 (5.2%)	12 (8.1%)	3 (2.1%)
16,000–23,999 KES	65 (22.6%)	33 (22.3%)	32 (22.9%)
24,000–55,000 KES	208 (72.2%)	103 (69.6%)	105 (75.0%)
Number of years worked as truck driver				0.650^a
Mean (SD)	8.7 (7.1)	9.0 (7.8)	8.4 (6.3)
Median (range)	6.7 (1.0–38.9)	6.7 (1.0–38.9)	6.7 (1.0–37.0)
Clinic is on usual trucking route				0.573
No	51 (16.8%)	24 (15.6%)	27 (18.0%)
Yes	253 (83.2%)	130 (84.4%)	123 (82.0%)
Number of nights away from home in the past 30 days				0.495^a
Mean (SD)	21.6 (5.6)	21.3 (5.9)	21.8 (5.3)
Median (range)	22.5 (0.0–30.0)	22.0 (0.0–30.0)	23 (2.0–30.0)
Came to clinic specifically for HIV testing				0.365
No	173 (56.7%)	84 (54.2%)	89 (59.3%)
Yes	132 (43.3%)	71 (45.8%)	61 (40.7%)
Sexually active in the past 6 months				0.116^b
No	6 (2.0%)	1 (0.7%)	5 (3.4%)
Yes	295 (98.0%)	152 (99.3%)	143 (96.6%)
Married (legal or common law)				0.999
No	51 (16.9%)	26 (16.9%)	25 (16.9%)
Yes	251 (83.1%)	128 (83.1%)	123 (83.1%)
Has other regular partner(s) on the trucking route				0.619
No	163 (53.4%)	85 (54.8%)	78 (52.0%)
Yes	142 (46.6%)	70 (45.2%)	72 (48.0%)
Paid for sex in the past 6 months				0.789
No	126 (44.1%)	65 (43.3%)	61 (44.9%)
Yes	160 (55.9%)	85 (56.7%)	75 (55.1%)
Always used condoms when had sex in the past 6 months (among those who had sex)				0.358
No	250 (85.9%)	127 (84.1%)	123 (87.9%)
Yes	41 (14.1%)	24 (15.9%)	17 (12.1%)
Ever tested for HIV before				0.259
No	25 (8.2%)	10 (6.5%)	15 (10.0%)
Yes	280 (91.8%)	145 (93.5%)	135 (90.0%)
Number of years since last HIV test among those ever tested				0.934^a
Mean (SD)	1.1 (1.6)	1.0 (1.4)	1.1 (1.9)
Median (range)	0.5 (0.1–12.0)	0.5 (0.1–7.4)	0.5 (0.1–12.0)
Ever self-tested for HIV among those who ever tested				0.499^b
No	276 (99.3%)	142 (98.6%)	134 (100.0%)
Yes	2 (0.7%)	2 (1.4%)	0 (0.0%)

^aMann-Whitney U test.

^bFisher’s exact test.

Table 2. HIV test uptake overall and by intervention status under intent-to-treat (i.e., by randomization assignment) and per protocol (i.e., by what was actually offered).

	Total, n (%)	SOC arm, n (%)	Choice arm, n (%)	Mantel Haenszel OR (95% CI) adjusting for strata	Mantel Haenszel p-value
Total as randomized	305 (100%)	155 (50.8%)	150 (49.2%)	NA	NA
Total per protocol	305 (100%)	156 (51.1%)	149 (48.9%)	NA	NA
Tested in clinic (intent-to-treat analysis)
Yes	233 (76.4%)	113 (72.9%)	120 (80.0%)	1.5 (0.9–2.7)	0.189
No	72 (23.5%)	42 (27.1%)	30 (20.0%)	NA	NA
Tested in clinic (per protocol analysis)^a
Yes	233 (76.4%)	114 (73.1%)	119 (79.9%)	1.5 (0.9–2.7)	0.196
No	72 (23.6%)	42 (26.9%)	30 (20.1%)	NA	NA
Tested either in clinic or took test kit for home use (intent-to-treat analysis)
Yes	244 (80.0%)	113 (72.9%)	131 (87.3%)	2.8 (1.5–5.4)	0.002
No	61 (20.0%)	42 (27.1%)	19 (12.7%)
Tested either in clinic or took test kit for home use (per protocol analysis)^a
Yes	244 (80.0%)	114 (73.1%)	130 (87.2%)	2.8 (1.5–5.4)	0.002
No	61 (20.0%)	42 (26.9%)	19 (12.8%)	NA	NA

^aOne participant in the choice arm was only offered the SOC HIV test.

Table 3. HIV test used and reasons given for the test choice among those offered choices who agreed to test (n = 130).

Reason for test selected	SOC test, n (%)	Supervised self-administered rapid oral test in the clinic, n (%)	Self-administered rapid oral HIV test take for home use, n (%)^a
Total	35 (26.9%)	84 (64.6%)	11 (8.5%)
Prefer provider to administer/interpret the test	28 (80.0%)	NA	NA
Prefer to administer/interpret the test myself	NA	13 (15.5%)	10 (90.9%)
Trust the provider can administer the test correctly	5 (14.3%)	NA	NA
Do not trust the provider to administer/interpret the test correctly	NA	1 (1.2%)	0 (0.0%)
Not confident that I could do the test correctly myself	6 (17.1%)	NA	NA
Feel confident that I can administer the test myself correctly	NA	21 (25.0%)	5 (45.5%)
Trust the provider to keep the results confidential	4 (11.4%)	NA	NA
Do not trust the provider to keep the results confidential	NA	1 (1.2%)	0 (0.0%)
Prefer to be the only one who knows my results	NA	1 (1.2%)	1 (9.1%)
Prefer to have someone with me when testing	1 (2.9%)	NA	NA
Prefer to be alone when testing	NA	1 (1.2%)	4 (36.4%)
Prefer to be with a partner or loved one when testing	NA	NA	5 (45.5%)
Feel uncomfortable in clinic settings	NA	NA	1 (9.1%)
Prefer a blood test	21 (60.0%)	NA	NA
Prefer an oral test	NA	13 (15.5%)	3 (27.3%)
Wanted to try the new test/curious about the new test	NA	75 (89.3%)	0 (0%)
Did not have time to stay at the clinic to test	NA	NA	3 (27.3%)

^aOnly offered to those in the choice arm who refused both in-clinic HIV testing options.

Table 4. HIV test results for those who tested by randomization arm.

	SOC Arm, n (%)	Choice Arm, n (%)
Total who tested	113 (100%)	131 (100%)
HIV-positive	2 (1.8%)	0 (0%)
HIV-negative	111 (98.2%)	131 (100%)
Refused to disclose (self-testers only)	NA	0 (0.0%)