# Usability of a blood-based HIV self-test kit in Lusaka province, Zambia: A cross-sectional analysis

## TL;DR

This study shows that a blood-based HIV self-test kit is easy to use and well-accepted in Zambia, offering a promising way to increase HIV testing.

## Contribution

The study provides the first evidence of blood-based HIV self-testing feasibility in Zambian clinical settings.

## Key findings

- 95% of participants found the HIV self-test kit easy to use.
- 83.6% followed the test instructions correctly and independently.
- 98.7% expressed willingness to use the test again and recommend it.

## Abstract

Despite progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets, Zambia faces persistent gaps in HIV testing coverage. The Ministry of Health implemented blood-based HIV self-testing (HIVST) to improve accessibility. This study evaluated the CheckNOW™ HIVST kit’s usability in Lusaka province health facilities.

To determine usability, awareness and user-friendliness of the CheckNOW™ HIVST among Zambian adults.

We conducted a cross-sectional study from 04 September 2023 – 22 September 2023 across four high-volume healthcare facilities. A total of 323 CheckNOW™ HIVST kits were distributed, with 316 consenting adults successfully enrolled in the study. Data were collected through structured questionnaires administered via face-to-face interviews following test completion, capturing information on socio-demographics, HIV testing history and user perception of the self-testing process. Descriptive statistics were employed for data analysis.

Among 316 participants, 56.3% (178/316) were female, and 41.5% (131/316) were aged 25–34 years. The majority (95.0%, 300/316; p < 0.001) found the CheckNOW™ kit easy to use, while 65.0% (206/316) had prior awareness of HIVST. Additionally, 83.6% (264/316; p < 0.001) followed the test instructions correctly and independently. A high proportion (98.7%, 312/316; p < 0.001) expressed willingness to test again, and 99.7% (315/316; p < 0.001) would recommend it to others.

The CheckNOW™ blood-based HIVST kit demonstrated high usability and ease of use, supporting its potential to expand HIV testing coverage in Zambia. However, increased awareness efforts are necessary to maximise uptake and ensure broader accessibility.

This study provides the first evidence that blood-based HIV self-testing is feasible and acceptable within Zambian clinical settings. It offers a critical new strategy to expand testing coverage and reach key populations by integrating self-testing into routine health services.