OraQuick® HIV Self-Test Study in Canada (OQHIVST)

  • STATUS
    Recruiting
  • days left to enroll
    36
  • participants needed
    900
  • sponsor
    Unity Health Toronto
Updated on 12 July 2022
antiretroviral
antiretroviral therapy
hiv test
pre-exposure prophylaxis (prep)
Accepts healthy volunteers

Summary

Oral fluid based HIV Self-testing (HIVST) provides another innovative and simple option to increase opportunities for HIV testing. At-home testing for HIV using oral fluid has been FDA approved and in use in the USA since 2012, and studies have also shown that interest and acceptability of HIVST with oral fluid is high in other global settings. However data for oral fluid based HIVST within key populations and those at high risk for HIV infection in Canada is limited.

This study involves around 900 persons who are non-healthcare professionals and inexperienced in HIV self-testing (intended users) and are presenting at clinic sites across Canada for HIV testing. It will evaluate the accuracy (sensitivity and specificity), usability (persons performs test correctly) and readability (persons successfully interpret test results) of the OraQuick® HIV Self-Test when performed by persons representing intended users living in Canada.

A final report of study results will be provided to the Test manufacturer for inclusion in the Health Canada license application process.

Description

Background and Rationale:

Self-testing for HIV is an approach with the potential to increase the access, uptake and frequency of HIV testing for those who may not otherwise test and remain undiagnosed. There is increasing evidence showing the acceptability and usability of HIV self-testing (HIVST) in various key populations. In 2016 the World Health Organization recommended HIVST as an alternative option to complement existing HIV testing opportunities. Since then, HIVST use has been scaling up rapidly; for example, Canada's first blood-based (fingerstick) HIV self-test was licensed for use in November 2020.

Oral fluid based HIVST provides another innovative and simple option to increase opportunities for HIV testing. At-home testing for HIV using oral fluid has been FDA approved and in use in the USA since 2012, and studies have also shown that interest and acceptability of HIVST with oral fluid is high in other global settings. However data for oral fluid based HIVST within key populations and those at high risk for HIV infection in Canada is limited.

Having a licensed oral fluid HIV self-test in addition to the licensed blood-based HIV self-test will allow individuals to choose what is best for them and increase the potential to reach the undiagnosed living with HIV.

Objective

This study will evaluate the accuracy, usability (persons performs test correctly) and readability (persons successfully interpret test results) of the OraQuick® HIV Self-Test when performed by persons representing intended users living in Canada.

Hypothesis

The OraQuick Self-test as performed by intended users (non-healthcare professional and inexperienced in HIV self-testing) will meet or exceed the accuracy, usability and label comprehension requirements from Health Canada for license as a Class IV in vitro diagnostic device for Canadian market entry.

Study Design:

This study was designed around the requirements set out in the Health Canada Guidance Document: "Guidance for Manufacturers of Human Immunodeficiency Virus (HIV) Rapid Diagnostic Tests (RDT's) for Use at Point of Care or Self Testing, 2017". It is an investigational device trial designed as a cross-sectional study which employs observational and interview-based methods.

Sample population:

The study population requirements published by Health Canada stipulates that the prospective study include: 900 lay persons with unknown HIV status including 400 persons at risk for HIV infection (e.g. intravenous drug users, men who have sex with men, etc.). Self-reported practices or behaviour will be used to define those at high risk.

A minimum of 900 participants (non-healthcare professional and inexperienced in HIV self-testing) will read the instructions for use and conduct the OraQuick® HIV Self-Test. They will not be provided any training prior to use of the test. A trained healthcare provider or researcher (trained Observer) will watch, and document use of the test and independently read the participants self-test result. The participants will then complete a questionnaire to share their opinion on usability and label comprehension of this test.

A minimum of 400 (of the 900) participants will also be provided five mock devices with different results and asked to interpret those results i.e. strong positive; weak positive, negative, invalid with no control and no test line, and invalid with no control and a positive test line. This will evaluate readability of this test.

All participants will also have a venous blood sample collected for testing of plasma at a central laboratory with a 4th generation (Ag/Ab combo) HIV enzyme immunoassay that will serve as the comparator method (laboratory reference testing). All self-tests will be confirmed using a Canadian standard HIV testing algorithm. The sensitivity and specificity of the self-test result will be calculated relative to the "clinical truth" of the participants' HIV status determined by the confirmatory test process, where applicable. Participants will be instructed to return to the clinic for a follow-up visit, two (2) weeks after self-testing to obtain their laboratory test results which will be their official result.

Study Intervention Details:

Participants will be recruited to the study when they come in for voluntary HIV testing (e.g. POC testing) at a minimum of 3 study sites (different geographic locations). If persons consent to participating, all those enrolled will voluntarily complete a questionnaire (collecting demographics and HIV medical history information) and then provide their venous whole blood sample (for standard of care, laboratory confirmatory testing and comparator method), complete the OraQuick® HIV Self-Test (read test instructions, sample collection, sample testing, result interpretation), complete mock result interpretation, and complete questionnaires - Visit 1 (day 1; about 60 minutes). All patients will be instructed to return to the clinic for a follow-up visit two (2) weeks later to obtain their laboratory test results (Visit 2; about 15 - 60 minutes), post -test counselling, and to be linked to appropriate care depending on the test results..

Patients may also have a point-of-care (POC) test conducted on site as part of the clinic's standard of care testing, outside of the protocol and after all study procedures for Visit 1 are completed.

Details
Condition HIV Testing, HIV Infections
Treatment OraQuick® HIV Self-Test
Clinical Study IdentifierNCT05020353
SponsorUnity Health Toronto
Last Modified on12 July 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Are known HIV positive
Are on antiretroviral therapy (ART) or anti-HIV medications for the treatment of HIV, either as pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) or experimental vaccine
Have any experience or have ever conducted a rapid diagnostic self-test for HIV or any other sexually transmitted and blood borne illnesses disease
Are currently participating in a concurrent trial of HIV self-tests
Are investigator site employees or immediate family members of sponsor or investigator site employee
Are a practicing medical healthcare professional (doctor, nurse or HIV counsellor that performs HIV testing with Rapid Tests)
Any condition which, in the opinion of the Observer, would make the participant unsuitable or unsafe for enrolment or could interfere with the completion of the assessment and questionnaire etc. or bias the outcome, e.g. being unable to see / read by forgetting to bring reading glasses, being intoxicated, acute sickness, visibly distressed
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Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

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If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

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Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

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