iAccess: HIV self-testing. Informed Consent Form.

Who are we?

We are researchers from the Department of Medicine at the University of Cape Town. We are doing research to explore the acceptability of HIV self-testing. If you decide to participate in this study, the HIV self test you have requested will be delivered to you free of charge (usually at a cost of R180). We would also like to do an interview with you at the end of the study to find out your experience of the HIV self-test service.

What are you being asked to do?

You will need to agree to take part by clicking the tick box at the bottom of this page. You will be asked to fill in your contact details (address and telephone number). The Iyeza Express Courier Service will be notified of your order, which will be delivered to the address that you have specified within 48 hours. You will then need to complete the HIV self-test. A counselor from the Desmond Tutu HIV Foundation will contact you 3 to 5 days after you have completed the HIV test to ask your about your experience with the service.

Benefits, risks, discomforts and inconveniences

This study will require you to complete an HIV self-test, where you will prick your finger and draw blood for the test. This may be experienced as painful, however no more painful than a regular HIV test.

Your participation is confidential

Your name will not be included in the study and the information will be kept safe and confidential. Your personal views will not be discussed with anyone. You do not have to take part, and you may choose to leave the study at any time.

If you have questions about the study you can call Philip Smith at 021 650 1895. If you have any questions about your rights as someone helping with research, there is a group of doctors and researchers whose job it is to make sure research is safe. If you have questions about this, you can call Dr Marc Blockman at 021 406 6492.

Information about this study has been given to you and you have had a chance to ask any questions you have had about the study.  We have told you that it is your decision about whether or not to be in the study. You can be in the research only if you want to, and you can decide not to be in the research at any time.

If, at this time, you voluntarily agree to take part in this study, please check the box below.

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Health Sciences Research Ethics Committee, Room E52-24, Groote Schuur
Hospital, Old Main Building. Telephone: 021 406 6338

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