Evidence map›Paper›PMID 40198638›Full record

ArticlePLOS digital health2025

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.

Ashlyn Beecroft, Aliasgar Esmail, Olivia Vaikla, Thomas Duchaine, Nora Engel, Chen Liang, Qihuang Zhang, Keertan Dheda, Nitika Pant Pai

Abstract read
In one paragraph

Article in PLOS digital health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ashlyn BeecroftDivision of Experimental Medicine, Department of Medicine. McGill University, Montreal, Quebec, Canada.
Aliasgar EsmailUniversity of Cape Town, Cape Town, South Africa.
Olivia VaiklaResearch Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
Thomas DuchaineDepartment of Medicine, McGill University, Montreal, Quebec, Canada.
Nora EngelDepartment of Health, Ethics & Society, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Chen LiangDivision of Experimental Medicine, Department of Medicine. McGill University, Montreal, Quebec, Canada.
Qihuang ZhangDepartment of Medicine, McGill University, Montreal, Quebec, Canada.
Keertan DhedaUniversity of Cape Town, Cape Town, South Africa.
Nitika Pant PaiDivision of Experimental Medicine, Department of Medicine. McGill University, Montreal, Quebec, Canada.ORCID https://orcid.org/0000-0002-4672-0500

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo reach UNAIDS 95-95-95 targets, digital HIV self-testing (HIVST) strategy aided by applications, platforms, and readers can engage young people and adults living with undetected HIV infection. Evidence on its acceptability, feasibility, impact exists, yet accuracy data are limited.

methodsA secondary data analysis of a quasi-RCT of digital HIVST in South Africa was performed. We hypothesized app-guided digital interpretation of oral self-test enhanced test accuracy. We compared accuracy between digital HIVST supervised vs. unsupervised (with/without healthcare worker). Self-test results were interpreted and uploaded by participants, compared using computer vision technology, against lab reference standard by trained healthcare professionals.

results1513 digital HIVST participants reported pooled Sensitivity (Sn) = 95.52% (95% CI, 94.48%-96.56%); Specificity (Sp): 99.93% (95% CI, 99.79%-100.06%); Positive predictive value (PPV): 99.22% (95% CI, 98.78%-99.67%); Negative Predictive Value (NPV): 99.57% (95% CI, 99.24%-99.90%). 565 participants on supervised digital HIVST, reported a pooled Sn: 93.65% (95% CI, 91.64-95.66); Sp: 100.00% (95% CI, 100.00-100.00); PPV: 100.00% (95% CI, 100.00-100.00); NPV: 99.21% (95% CI, 98.48-99.94). 968 unsupervised digital HIVST participants, reported a pooled Sn: 97.18% (95% CI, 96.13-98.24); Sp: 99.89% (95% CI, 99.67-100.10); PPV: 98.57% (95% CI, 97.82-99.33); NPV: 99.77% (95% CI, 99.47-100.08). Non-digital HIVST vs. study digital HIVST data at 5% significance level - Sn: chi = 0.6495, p-value = 0.4203, Sp: chi = 0.3831, p-value = 0.5259. Supervised vs. unsupervised HIVST at 5% significance level - Sn: chi = 0.973, p-value = 0.3237, Sp: chi = 0.527, p-value = 0.4449.

conclusionsDigital HIVST improved interpretation of test results, increased accuracy and predictive value estimations (upper limit 98%-100%), removing subjectivity. Unsupervised digital HIVST users performed better than supervised. Digital HIVST results can potentially signal a rapid triage to therapy or prevention pathways, while awaiting lab confirmation. Findings have implications for scale up of digital HIVST initiatives in global settings.

Identifiers

PMID40198638
PMCPMC11977960

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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.