{ "abstract": "Home-based self-testing may improve individual health outcomes and public health programs by lowering barriers associated with clinic-based testing in low- and middle-income countries (LMICs). We assessed the acceptability and usability of conducting home-based self-testing for HIV and blood glucose and home-based researcher-conducted testing for blood pressure in sub-Saharan Africa. We enrolled participants (≥15 years old) from households in peri-urban and rural communities of Kenya, South Africa, and Zambia. Participants opted in to self-directed testing for HIV and blood glucose and had their blood pressure measured by a research team member. Our primary measures included HIV status and testing history, HIV and blood glucose test results, blood pressure, self-reported usability and acceptability of self-testing, and participant preferences for future self-testing. Among the 526 participants from 100 households enrolled per country, the average age was 41 years and 63% were female. Overall, 16% of participants reported living with HIV. Over half of participants (52%) had last tested for HIV > 12 months ago or had never tested for HIV, and 8% of participants were unsure of their HIV status. Among participants who self-tested, 2% (n = 6/330) tested positive for HIV and 4% (n = 18/469) had high blood glucose, while 26% (n = 131/502) had high blood pressure measured by the study team. Only 14% of study participants reported previous self-testing. Most (>90%) participants who self-tested rated all procedures for HIV and blood glucose tests as either “very easy” or “fairly easy” to use. Most participants (87%, n = 458/526) preferred home-based testing. Home-based self-testing for HIV and blood glucose and home-based blood pressure measurement were acceptable, usable and preferred in peri-urban and rural areas of Kenya and South Africa; findings from Zambia suggest promise for home-based testing but were limited by staff-administered HIV tests. Self-testing has the potential to expand and accelerate access to healthcare delivery in LMICs.", "abstract_shown": true, "affiliations": [ "University of Washington School of Medicine, Seattle, Washington, United States of America", "Department of Global Health, University of Washington, Seattle, Washington, United States of America", "Audere, Seattle, Washington, United States of America", "Audere, Johannesburg, South Africa", "Human Sciences Research Council, Pretoria, South Africa", "Centre for Infectious Disease Research in Zambia, Lusaka, Zambia", "Akros Research, Lusaka, Zambia", "Akros Research, Missoula, Montana, United States of America", "SAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa", "Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya", "Vanderbilt University Medical Centre, Nashville, Tennessee, United States of America", "Department of Epidemiology, University of Washington, Seattle, Washington, United States of America" ], "article_type": "Research Article", "arxiv": null, "author_total": 13, "authors": [ { "affs": [ 0 ], "name": "Carolyn R. Oliver" }, { "affs": [ 1 ], "name": "Meagan J. Bemer" }, { "affs": [ 2 ], "name": "Amber Lauff" }, { "affs": [ 3 ], "name": "Jennifer F. Morton" }, { "affs": [ 4 ], "name": "Shawna Cooper" }, { "affs": [ 5 ], "name": "Hilton Humphries" }, { "affs": [ 6 ], "name": "Anjali Sharma" }, { "affs": [ 7 ], "name": "Derek Pollard" }, { "affs": [ 8 ], "name": "Anna Winters" }, { "affs": [ 9 ], "name": "Alastair van Heerden" }, { "affs": [ 10 ], "name": "Elizabeth Bukusi" }, { "affs": [ 11 ], "name": "Dino Rech" }, { "name": "Paul K. Drain" } ], "bibtex": "https://research.draconitic.com/paper/aqe4a4ndb6dgf.bib", "cited_by": 0, "doi": "10.1371/journal.pgph.0005445", "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005445", "id": "aqe4a4ndb6dgf", "issns": [ "2767-3375" ], "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005445", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2725|HIV/AIDS Research and Interventions" ], [ "plos", "/Biology and life sciences/Anatomy/Body fluids/Blood/Blood sugar" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/RNA viruses/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Biology and life sciences/Physiology/Body fluids/Blood/Blood sugar" ], [ "plos", "/Medicine and health sciences/Anatomy/Body fluids/Blood/Blood sugar" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine/Virus testing" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV" ], [ "plos", "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV" ], [ "plos", "/Medicine and health sciences/Vascular medicine/Blood pressure" ], [ "plos", "/Medicine and health sciences/Vascular medicine/Blood pressure/Hypertension" ], [ "plos", "/People and places/Geographical locations/Africa/Kenya" ], [ "plos", "/People and places/Geographical locations/Africa/South Africa" ], [ "plos", "/People and places/Geographical locations/Africa/Zambia" ] ], "openalex": "W7214318206", "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0005445&type=printable", "pmcid": null, "pmid": null, "published": "2026-09-25", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/aqe4a4ndb6dgf.ris", "sources": [ { "first_seen": "2026-10-30T12:17:43Z", "native_id": "10.1371/journal.pgph.0005445", "source": "plos", "url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005445" } ], "subjects": [ { "field": "biology", "origin": "plos:microbiology", "subfield": "microbiology" }, { "field": "medicine", "origin": "plos:anatomy", "subfield": "physiology" } ], "title": "Acceptability and usability of home-based HIV and blood glucose self-testing and home-based blood pressure measurement in Kenya, South Africa, and Zambia", "title_text": "Acceptability and usability of home-based HIV and blood glucose self-testing and home-based blood pressure measurement in Kenya, South Africa, and Zambia", "type": "peer-reviewed", "updated_at": "2026-10-30T12:17:43Z", "url": "https://research.draconitic.com/paper/aqe4a4ndb6dgf", "venue": "PLOS Global Public Health", "versions": [] }