Acceptability, Usability, and Clinical Appropriateness of an AI-Powered Tool for Linkage to HIV Services After HIV Self-Testing in South Africa: Mixed Methods Evaluation.

Background: Timely linkage to HIV prevention and treatment services following HIV self-testing (HIVST) remains a challenge in many countries. While HIVST offers privacy and convenience for individuals to know their HIV status, many do not engage in follow-up care due to behavioral barriers like uncertainty about next steps, stigma, and privacy concerns. Objective: This study evaluated the acceptability, usability, and clinical appropriateness of Your Path, an AI-powered tool designed to facilitate access to HIV services following HIVST. Methods: This study was conducted with community members and health care providers, recruited from Indlela's Behavioral Hub in South Africa. Community members were randomly assigned a mock HIV result and completed a pretest survey assessing intentions to seek HIV services, followed by a simulated HIVST guided by Your Path Results: A sample of 100 community members aged between 18 and 61 years was enrolled: 59 (59%) were female, and 51 (51%) were assigned a negative mock HIV result. Overall, the intervention had its strongest effect on participants' confidence in accessing HIV services, particularly among those with HIV-negative results (Wilcoxon Conclusions: Your Path was acceptable, usable, and clinically appropriate for supporting access to HIV services after HIVST. Larger in-field studies are needed to understand the implementation, cost, and sustainability of digital interventions in public health.