***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: We evaluated performance , accuracy , and acceptability parameters of unsupervised oral fluid ( OF ) HIV self-testing ( HIVST ) in a general population in western Kenya . In a prospect i ve validation design , we enrolled 240 adults to perform rapid OF HIVST and compared results to staff administered OF and rapid fingerstick tests . All reactive , discrepant , and a proportion of negative results were confirmed with lab ELISA . Twenty participants were video-recorded conducting self-testing . All participants completed a staff administered survey before and after HIVST to assess attitudes towards OF HIVST acceptability . HIV prevalence was 14.6 % . Thirty-six of the 239 HIVSTs were invalid ( 15.1 % ; 95 % CI 11.1–20.1 % ) , with males twice as likely to have invalid results as females . HIVST sensitivity was 89.7 % ( 95 % CI 73–98 % ) and specificity was 98 % ( 95 % CI 89–99 % ) . Although sensitivity was somewhat lower than expected , there is clear interest in , and high acceptability ( 94 % ) of OF HIV self-testing Unsupervised HIV self-testing ( HST ) has potential to increase knowledge of HIV status ; however , its accuracy is unknown . To estimate the accuracy of unsupervised HST in field setting s in Ug and a , we performed a non-blinded , r and omized controlled , non-inferiority trial of unsupervised compared with supervised HST among selected high HIV risk fisherfolk ( 22.1 % HIV Prevalence ) in three fishing villages in Ug and a between July and September 2013 . The study enrolled 246 participants and r and omized them in a 1:1 ratio to unsupervised HST or provider-supervised HST . In an intent-to-treat analysis , the HST sensitivity was 90 % in the unsupervised arm and 100 % among the provider-supervised , yielding a difference 0f −10 % ( 90 % CI −21 , 1 % ) ; non-inferiority was not shown . In a per protocol analysis , the difference in sensitivity was −5.6 % ( 90 % CI −14.4 , 3.3 % ) and did show non-inferiority . We conclude that unsupervised HST is feasible in rural Africa and may be non-inferior to provider-supervised HST Objectives In order to assess whether the BioSure HIV Self-Test could be reliably performed by users at home and to determine whether they were able to perform and correctly interpret the test , we carried out an evaluation study among attendees at a sexual health service . Methods A prospect i ve observational study of clinic attendees to determine their ability to follow the instructions , complete the test on themselves and correctly interpret the results . The evaluation included interpretation of three dummy ( contrived ) devices , chosen at r and om from a sample of 12 devices , to ensure that a sufficient number of all possible test outcomes were included . Results Two hundred participants were recruited . 97.0 % ( 95 % CI 93.5 to 98.9 ) conducted the test so as to achieve a valid result . 99.5 % correctly identified the test result . Participants correctly interpreted the result of 94.0 % ( 95 % CI 91.4 to 95.9 ) of 586 contrived devices . Conclusions The majority of participants were able to follow the instructions and perform the test in order to get a valid result . Interpretation of the test results was good and the majority of participants were able to correctly read the result of their own and contrived tests . The availability of HIV self-tests will provide another option to increase access to testing particularly for those who may not wish or are unable to access clinical services BACKGROUND Point-of-care ( POC ) rapid HIV tests have sensitivity during the " window period " comparable only to earliest generation EIAs . To date , it is unclear whether any POC test performs significantly better than others . OBJECTIVE Compare abilities of POC tests to detect early infection in real time . STUDY DESIGN Men who have sex with men ( MSM ) were recruited into a prospect i ve , cross-sectional study at two HIV testing sites and a research clinic . Procedures compared four POC tests : one performed on oral fluids and three on fingerstick whole blood specimens . Specimens from participants with negative POC results were tested by  EIA and pooled nucleic acid amplification testing ( NAAT ) .  McNemar 's exact tests compared numbers of HIV-infected participants detected . RESULTS Between February 2010 and May 2013 , 104 men tested HIV-positive during 2479 visits . Eighty-two participants had concordant reactive POC results , 3 participants had concordant non-reactive POC tests but reactive EIAs , and 8 participants had acute infection . Of 12 participants with discordant POC results , OraQuick ADVANCE Rapid HIV-1/2 Antibody Test performed on oral fluids identified fewer infections than OraQuick performed on fingerstick ( p = .005 ) , Uni-Gold Recombigen HIV test ( p = .01 ) , and determine HIV-1/2 Ag/Ab combo ( p = .005 ) . CONCLUSIONS These data confirm that oral fluid POC testing detects fewer infections than other methods and is best reserved for circumstances precluding fingerstick or venipuncture . Regardless of specimen type , POC tests failed to identify many HIV-infected MSM in Seattle . In population s with high HIV incidence , the currently approved POC antibody tests are inadequate unless supplemented with p24 antigen tests or NAAT 
    Output:
    
The most common error that affected test performance was incorrect specimen collection ( oral swab or finger prick ) .
INTERPRETATION Self-testers can reliably and accurately do HIV rapid diagnostic tests , as compared with trained health-care workers .