Performance and usability of OraQuick oral fluid-based rapid HIV self-test among key populations in Vietnam

The study involved 200 inexperienced lay users, including men who have sex with men, transgender women, female sex workers, and people who inject drugs. Participants were aged 18 years and older and were able to provide informed consent. The study consisted of four steps: using the OraQuick HIV Self-Test under observation, interpreting mock device results, participating in computer-assisted personal interviewing, and receiving HIV counseling. Participants who revealed a reactive result were referred to an HIV testing center for confirmatory testing and linked to antiretroviral treatment if their result was confirmed. The majority of users could correctly interpret strong reactive, non-reactive, and invalid test results. However, only 55% of users could correctly interpret weak reactive test results. When performing the self-test, 98.5% of users could correctly read the instruction sheet, 100% could find the tube, and 89% could remove the cap from the tube. However, 73.5% of users failed to collect the sample as instructed. The majority of users reported they would visit the nearest HIV testing facility for confirmatory testing if they received a reactive result. Users also reported confidence in repeat performance of the OraQuick HIV self-test and indicated they would use the test when available and introduce it to others. However, a significant proportion of users were not aware of factors affecting the test result, including the time to test after using mouth cleaning products and the false result when taking antiretroviral treatment. The study found that participants read the instruction sheet with ease but struggled with using the swab and reading the result within the recommended time frame. The instruction sheet can be improved by stressing the correct result read time, emphasizing the correct sampling method, and clearly denoting differences between weak reactive and non-reactive test results. The study suggests that the OraQuick oral fluid-based rapid HIV self-test is acceptable and usable among key populations in Vietnam, but further improvements to the instruction sheet are needed to ensure accurate use of the test.