***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : The current study identifies young people 's preferences for  HIV self-testing ( HIVST )  delivery , determines the relative strength of preferences and explores underlying behaviors and perceptions to inform youth-friendly services in southern Africa . Design : A mixed methods design was adopted in Malawi and Zimbabwe and includes focus group discussion s , in-depth interviews and discrete choice experiments . Methods : The current study was conducted during the formative phase of cluster-r and omized trials of oral-fluid HIVST distribution . Young people aged 16–25 years were purposively selected for in-depth interviews ( n = 15 ) in Malawi and 12 focus group discussion s ( n = 107 ) across countries . Representative sample s of young people in both countries ( n = 341 ) were administered discrete choice experiments on HIVST delivery , with data analyzed to estimate relative preferences . The qualitative results provided additional depth and were triangulated with the quantitative findings . Results : There was strong concordance across methods and countries based on the three triangulation parameters : product , provider and service characteristics .  HIVST  was highly accepted by young people , if provided at no or very low cost . Young people expressed mixed views on oral-fluid tests , weighing perceived benefits with accuracy concerns . There was an expressed lack of trust in health providers and preference for lay community distributors . HIVST addressed youth-specific barriers to st and ard HIV testing , with home-based distribution considered convenient . Issues of autonomy , control , respect and confidentiality emerged as key qualitative themes . Conclusion : HIVST services can be optimized to reach young people if products are provided through home-based distribution and at low prices , with respect for them as autonomous individuals Abstract Introduction : In the era of ambitious HIV targets , novel HIV testing models are required for hard-to-reach groups such as men , who remain underserved by existing services . Pregnancy presents a unique opportunity for partners to test for HIV , as many pregnant women will attend antenatal care ( ANC ) . We describe the views of pregnant women and their male partners on HIV self-test kits that are woman-delivered , alone or with an additional intervention . Methods : A formative qualitative study to inform the design of a multi-arm multi-stage cluster-r and omized trial , comprised of six focus group discussion s and 20 in-depth interviews , was conducted . ANC attendees were purposively sample d on the day of initial clinic visit , while men were recruited after obtaining their contact information from their female partners . Data were analysed using content analysis , and our interpretation is hypothetical as participants were not offered self-test kits . Results : Providing HIV self-test kits to pregnant women to deliver to their male partners was highly acceptable to both women and men . Men preferred this approach compared with st and ard facility-based testing , as self-testing fits into their lifestyles which were characterized by extreme day-to-day economic pressures , including the need to raise money for food for their household daily . Men and women emphasized the need for careful communication before and after collection of the self-test kits in order to minimize the potential for intimate partner violence although physical violence was perceived as less likely to occur . Most men stated a preference to first self-test alone , followed by testing as a couple . Regarding interventions for optimizing linkage following self-testing , both men and women felt that a fixed financial incentive of approximately USD$2 would increase linkage . However , there were concerns that financial incentives of greater value may lead to multiple pregnancies and lack of child spacing . In this low-income setting , a lottery incentive was considered overly disappointing for those who receive nothing . Phone call reminders were preferred to short messaging service . Conclusions : Woman-delivered HIV self-testing through ANC was acceptable to pregnant women and their male partners . Feedback on additional linkage enablers will be used to alter pre-planned trial arms Background Partner services ( PSs ) are a long-st and ing component of HIV control programs in the United States and some parts of Europe . Small r and omized trials suggest that HIV PS can be effective in identifying persons with undiagnosed HIV infection . However , the scalability and effectiveness of HIV PS in low-income countries are unknown . Methods We used data collected from 2009 to 2010 through a large HIV PS program in Cameroon to evaluate HIV PS in a developing country . HIV-positive index cases diagnosed in antenatal care , voluntary counseling and testing , and inpatient facilities were interviewed to collect information on their sexual partners . Partners were contacted via telephone or home visit to notify , test , and enroll those found to be HIV positive in medical care . Results Health advisors interviewed 1462 persons with HIV infection during the evaluation period ; these persons provided information about 1607 sexual partners . Health advisors notified 1347 ( 83.8 % ) of these partners , of whom 900 ( 66.8 % ) were HIV tested . Of partners tested , 451 ( 50.1 % ) were HIV positive , of whom 386 ( 85.6 % ) enrolled into HIV medical care . An average 3.2 index cases needed to be interviewed to identify 1 HIV case . Conclusions HIV PS can be successfully implemented in a developing country and is highly effective in identifying persons with HIV infection  and linking them to care Reaching universal HIV-status awareness is crucial to ensure all HIV-infected patients access antiretroviral treatment ( ART ) and achieve virological suppression . Opportunities for HIV testing could be enhanced by offering self-testing in population s that fear stigma and discrimination when accessing conventional HIV Counselling and Testing ( HCT ) in health care facilities . This qualitative research aims to examine the feasibility and acceptability of  unsupervised oral self-testing for home use in an informal settlement of South Africa . Eleven in-depth interviews , two couple interviews , and two focus group discussion s were conducted with seven healthcare workers and thirteen community members . Thematic analysis was done concurrently with data collection . Acceptability to offer home self-testing  was demonstrated in this research . Home self-testing might help this population overcome barriers to accepting HCT ; this was particularly expressed in the male and youth groups . Nevertheless , pilot interventions must provide evidence of potential harm related to home  self-testing  , intensify efforts to offer quality counselling , and ensure linkage to HIV/ART-care following a positive self-test result The objective of this study is to describe HIV-testing among men in rural Lusaka Province , Zambia , using a population -based survey for a cluster-r and omized trial . Households ( N = 120 ) were r and omly selected from each of the 42 clusters , defined as a health facility catchment area . Individuals aged 15–60 years were invited to complete question naires regarding demographics and  HIV-testing  history . Men testing in the last year were defined as recent-testers . After question naire completion adults were offered home-based rapid HIV-testing . Of the 2,828 men , 53 % reported ever-testing and 25 % recently-testing . Factors independently associated with ever- and recent-testing included age 20 + years , secondary /higher education , being married or widowed , a history of TB-treatment and higher socioeconomic position . 53 % of never-testers and 57 % of men who did not report a recent-test accepted  home-based HIV-testing .  Current HIV-testing approaches are inadequate in this high prevalence setting . Alternative strategies , including self-testing , mobile- or workplace-testing  , may be required to complement facility-based services OBJECTIVES To examine factors affecting readiness for and acceptability of  voluntary HIV counselling  and testing ( VCT ) . METHODS Participants in a population -based HIV survey conducted in an urban population in Zambia in 1996 were offered VCT . Although 29 % of them expressed interest in being tested ( readiness ) , only 4 % of this group used the services ( i.e. acceptability ) . When the survey was repeated 3 years later , VCT was design ed differently to assess acceptability . At the cluster level the participants were r and omly allocated to VCT either at the local clinic  ( similar to 1996 , n = 1102 ) or at an optional location  ( n = 1343 ) . RESULTS Readiness varied significantly by age group ( 47 % in age group 20 - 24 years vs. 18 % in age group 40 - 49 years ) . There were contrasts between young ( 15 - 24 years ) and older age groups ( 25 - 49 years ) regarding the main factors associated with readiness . Whereas self-perceived risk of being HIV infected was the only significant factor among the young , poor self-rated health and ever HIV tested were important factors among the older . The acceptability was 11.8 % among the group allocated to VCT at the local clinic compared with 55.8 % for the group allocated to an optional location ( RR , 4.7 ) . CONCLUSIONS Perceived risk of HIV infection had a major influence on VCT readiness among young people , whereas declining general health status , as indicated by self-rated health , was most evident among those of older age . A strong effect of placement on acceptability of VCT was demonstrated , indicating this barrier to be important in explaining low dem and s for VCT in the past . Differences in perceptions of how confidentiality is h and led at the two locations might be an important underlying factor BACKGROUND HIV testing is important among female sex workers ( FSWs ) because they are at increased risk of HIV acquisition compared with members of the general population .1,2 The World Health Organization recommends that FSWs retest for HIV frequently to detect early HIV infection.3 Frequent HIV testing is also important for engagement in HIV prevention interventions , including treatment as prevention4,5 and pre-exposure prophylaxis.6,7 HIV self-testing is a promising new HIV testing strategy in sub-Saharan Africa ( SSA ) that has been shown to increase HIV testing in diverse population s.8–14 The benefits of HIV testing ( eg , initiation of HIV care , prevention behaviors ) , however , rely on correct interpretation of self-test results . HIV self-testing r and omized controlled trials among FSWs in Ug and a13 and Zambia14 found that HIV self-testing achieved near-universal HIV testing coverage and substituted for facility-based testing . In traditional HIV testing and counseling , HIV test results are interpreted by a trained health care professional . With HIV self-testing , the tester must correctly interpret the self-test results without professional assistance and often only the aid of the manufacturer ’s self-test instructions . A number of oral HIV self-testing performance studies conducted in SSA found high participant-interpreted HIV self-test sensitivity and specificity ( $ 94 % sensitivity and .98 % specificity).15–24 In most of these studies , participants received pretest training and interpreted their own self-test result .15– 22,24 None of these HIV self-testing performance studies were conducted among FSWs,15–24 an important key population for HIV prevention interventions . We explore how well FSWs in Kampala , Ug and a , who received pretest training and had 2 previous opportunities to HIV self-test , can interpret images of HIV self-test results ABSTRACT Successful implementation of Universal Test and Treat as a strategy to achieve the 90 - 90 - 90 target requires higher HIV testing rates . Currently , uptake of HIV testing is not optimal which has directed research initiatives towards identification of additional HIV testing methods . HIV self-testing ( HIVST ) has received growing attention as a complementary testing approach as it overcomes barriers that are commonly associated with current HIV testing methods . In sub-Saharan Africa , acceptability rates showed a gendered pattern of men benefitting more than women , with limited evidence to explain this difference . This study assessed whether men or women in KwaZulu-Natal displayed a higher acceptance of HIVST  and also explored factors that influenced and motivated their acceptability .  Participants were recruited through purposive sampling at two clinical research sites to participate and underwent qualitative assessment  s. The outcomes from focus group discussion s coupled with findings from a scoping review informed the design and data collection instruments for in-depth interviews . A r and omised cross-over study design exposed participants to HIV counselling and testing and HIVST , accompanied by before ( baseline ) and after in-depth interviews . HIVST was acceptable among most participants with acceptability higher in women . Men preferred HIVST due to convenience and efficiency , whilst women favoured HIVST due to its potential to provide autonomy and empowerment . Also , lack of HIV counselling and managing a positive HIV result as well as linkage to care were raised as deterrents of HIVST . As HIVST was acceptable by most participants , future research efforts should be directed towards evaluating the feasibility of its introduction into the public health sector ABSTRACT Background : HIV self-testing ( HIVST ) can improve HIV-testing rates in ‘ hard-to-reach ’ population s , including men . We explored HIVST perceptions , delivery strategies , and post-test experiences among pregnant women and their male partners in Central Ug and a. Methods : This was a qualitative study implemented as part of a pilot , cluster-r and omized oral HIVST intervention trial among 1,514 pregnant women attending antenatal care services at three health facilities in Central Ug and a. The qualitative component of the study was conducted between February and March 2017 . We conducted 32 in-depth interviews to document women and men ’s perceptions about HIVST , strategies used by women in delivering the kits to their male partners , male partners ’ reactions to receiving kits from their female partners , and positive and negative social outcomes post-test . All interviews were audio-recorded , transcribed verbatim , and analyzed manually following a thematic framework approach . Results : Women were initially anxious about their male partners ’ reaction if they brought HIVST kits home , but the majority eventually managed to deliver the kits to them successfully . Women who had some level of apprehension used a variety of strategies to deliver the kits including placing the kits in locations that would arouse male partners ’ inquisitiveness or waited for 
    Output:
    
The study shows that while HIVST provides men with an alternative , confidential and convenient testing model , the potential for psychological and physical harm remains a challenge .
The introduction of the HIVST strategy has the potential of improving men ’s uptake in HIV testing services , thereby contributing towards addressing the first cascade of the 90–90 - 90 strategy .
While HIVST has a potential for addressing men ’s barriers to attending clinic setting s , such as confidentiality and convenience , it barely addresses the HIVST counselling and accuracy concerns