ArticleBMJ global health2021
Impact of a personalised, digital, HIV self-testing app-based program on linkages and new infections in the township populations of South Africa.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Evidence on Digital HIV Self-Testing From Accuracy to Impact: Updated Systematic Review.Journal of medical Internet research · 2025Pooled it
- Effectiveness of Linkage to Care and Prevention Interventions Following HIV Self-Testing: A Global Systematic Review and Meta-analysis.AIDS and behavior · 2024Pooled it
- Counseling Supporting HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men: Systematic Review and Meta-Analysis.JMIR public health and surveillance · 2024Pooled it
- mHealth Interventions to Promote HIV Self-Testing Among Key Populations: A Systematic Review of Effectiveness and Implementation Outcomes.Journal of the International Association of Providers of AIDS CarePooled it
- Chatbot-Delivered Real-Time Support to Improve HIV Self-Testing Rates: A Randomized Clinical Trial.JAMA network open · 2025Trial
- HIV self-testing and the global diagnostic gap: Addressing a decade of missed opportunity.PLoS medicine · 2026Article
- Acceptability, Usability, and Clinical Appropriateness of an AI-Powered Tool for Linkage to HIV Services After HIV Self-Testing in South Africa: Mixed Methods Evaluation.Journal of medical Internet research · 2026Article
- A User-Centered Approach to Achieving High Degree of Digital Health Technology Utilization for Community HIV Case Management and Data Collection in Ethiopia.Global health, science and practice · 2026Article
- HIV Self-Test Experiences and Implementation Considerations Among Transgender Women in the Philippines: Getting Ready for Scale-Up.AIDS education and prevention : official publication of the International Society for AIDS Education · 2025Article
- Exploring the diagnostic accuracy of an HIV self-test optimized by a digital app-based solution: Results from a secondary data analysis of a field trial in South Africa.PLOS digital health · 2025Article
- Article
- Preventing Unintended Pregnancies and HIV Through Self-Care Interventions in East and Southern Africa: Findings From a Structured Review.Public health reviews · 2025Review
- Developing a youth-friendly internet-enabled HIV risk calculator: A collaborative approach with young key populations, living in Soweto, South Africa.PLOS digital health · 2025Article
- Patient evaluation of Klick, a technology-enabled, nurse-delivered HIV outpatient pathway.HIV medicine · 2025Article
- How to make an app-based program work and show how it works.PLOS global public health · 2025Article
- Clients' and providers' perspectives in informing a digital health intervention to improve linkage to care after Index HIV self-testing in Hai and Moshi Districts, Tanzania.BMC health services research · 2024Article
- HIV self-testing in India: implementation and qualitative evaluation of a web-based programme with virtual counsellor support.Journal of the International AIDS Society · 2024Article
- Challenges and Facilitators for HIV Testing Services and HIV Self-Testing Programming During Emergency Care in Kenya: A Qualitative Study of Patients.Journal of sexual health and AIDS research · 2024Article
- Digital Intervention Services to Promote HIV Self-Testing and Linkage to Care Services: A Bibliometric and Content Analysis-Global Trends and Future Directions.Public health reviews · 2024Review
- Community-friendly diagnostics: Who are tests for?PLOS global public health · 2024Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 4 countries.
Funding
Abstract
introductionImplementation data for digital unsupervised HIV self-testing (HIVST) are sparse. We evaluated the impact of an app-based, personalised, oral HIVST program offered by healthcare workers in Western Cape, South Africa.
methodsIn a quasirandomised study (n=3095), we recruited consenting adults with undiagnosed HIV infection from township clinics. To the HIVST arm participants (n=1535), we offered a choice of an offsite (home, office or kiosk based), unsupervised digital HIVST program (n=962), or an onsite, clinic-based, supervised digital HIVST program (n=573) with 24/7 linkages services.With propensity score analyses, we compared outcomes (ie, linkages, new HIV infections and test referrals) with conventional HIV testing (ConvHT) arm participants (n=1560), recruited randomly from geographically separated clinics.
resultsIn both arms, participants were young (HIVST vs ConvHT) (mean age: 28.2 years vs 29.2 years), female (65.0% vs 76.0%) and had monthly income <3000 rand (80.8% vs 75%).Participants chose unsupervised HIVST (62.7%) versus supervised HIVST and reported multiple sex partners (10.88% vs 8.7%), exposure to sex workers (1.4% vs 0.2%) and fewer comorbidities (0.9% vs 1.9%). Almost all HIVST participants were linked (unsupervised HIVST (99.7%), supervised HIVST (99.8%) vs ConvHT (98.5%)) (adj RR 1.012; 95% CI 1.005 to 1.018) with new HIV infections: overall HIVST (9%); supervised HIVST (10.9%) and unsupervised HIVST (7.6%) versus ConvHT (6.79%) (adj RR 1.305; 95% CI 1.023 to 1.665); test referrals: 16.7% HIVST versus 3.1% ConvHT (adj RR 5.435; 95% CI 4.024 to 7.340).
conclusionsOur flexible, personalised, app-based HIVST program, offered by healthcare workers, successfully linked almost all HIV self-testers, detected new infections and increased referrals to self-test. Data are relevant for digital HIVST initiatives worldwide.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.