Can we improve HIV self-testing outcomes through digital data capture? A retrospective review of the HIVST Challenge Fund Project in Kenya

BACKGROUND: The 2018 KENPHIA report indicated that only 79.4% Kenyans know their HIV status. Following the introduction of the HIVST modality to accelerate access to HIV testing for unreached subpopulations, questions regarding optimal strategies to ensure timely linkage to post-testing persist. This paper explores if digital data management enhances support and result reporting among HIVST clients.
DESCRIPTION: Beginning October 2019 PS Kenya, a Kenyan NGO, implemented HIVST program that delivers targeted free HIVST kits through Community Based Organizations (CBOs).
At inception of the project, between October 2019 to March 2020, paper-based tools were used by the CBO members to capture key indicators. Completed forms were mailed back to PS Kenya for transcription and feedback shared with HTS providers for follow up. As from April 2020, this process was automated to Health Information System (DHIS 2) using android application. CBO entered data directly into DHIS2 using tablets making data accessible to HTS providers for immediate follow up.
Turnaround time (TAT) was computed by deducting the distribution time from follow-up initiation time. Proportion of clients reached was calculated as a percentage of clients who consented for follow-up. We defined reach as clients that were contacted and responded to the calls or messages sent. Finally, positivity was computed by comparing HIV positive results and all self-test results.
LESSONS LEARNED: Between October 2019 and March 2020, the TAT averaged 10 days. Of the 12,719 clients who opted for follow up, only 1,152 (9%) were reached. Overall positivity was estimated at 0.7%.
From April to September 2020, TAT reduced to an average of 1.5 days. Of the 31,416 clients who opted for follow up, 10,908 (35%) were reached (26% improvement from previous period) with a positivity of 4.2%.
The difference in proportions in reach with paper-based data entry and digital data entry were found to be statistically significant (P-value <0.05).
CONCLUSIONS: Digital data capture shortens follow-up TAT and early contacting enables clients to share results and obtain timely support. Programs should consider digital data capture to increase efficiency.