scholarly journals ‘I will welcome this one 101%, I will so embrace it’: a qualitative exploration of the feasibility and acceptability of HIV self-testing among men who have sex with men (MSM) in Lagos, Nigeria

2020 ◽  
Vol 35 (6) ◽  
pp. 524-537
Author(s):  
Osasuyi Dirisu ◽  
Adekemi Sekoni ◽  
Lung Vu ◽  
Sylvia Adebajo ◽  
Jean Njab ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Linkage To Care ◽  
Group Discussions ◽  
Innovative Strategy ◽  
Self Testing ◽  
Post Test ◽  
Distribution Process ◽  
Testing Uptake ◽  
Sex With Men ◽  
Qualitative Exploration

Abstract Men who have sex with men (MSM) are disproportionately affected by HIV in Nigeria. A key strategy in reducing transmission is to increase HIV testing uptake and linkage to treatment for those who test positive. HIV self-testing (HIVST) is an innovative strategy with the potential to increase uptake of HIV testing among key populations at higher risk for HIV. We conducted 23 in-depth-interviews with MSM and two focus group discussions with key opinion leaders to explore perceptions about the feasibility and acceptability of oral HIVST among MSM in Lagos, Nigeria. HIVST was highly acceptable because it was considered convenient to use, painless, private and addressed concerns about stigma. Concerns cited by participants included comprehensibility of instructions to perform and interpret results correctly, as well as lack of support mechanisms to facilitate post-test follow-up and linkage to care. Provision of adequate pre-test information was considered vital as part of the kit distribution process to ensure seamless use of HIVST kits. One-on-one peer-to-peer distribution strategies and retail outlets that facilitate anonymous pick-up are potential distribution channels identified in this study. Overall, our findings suggest that an HIVST program that incorporates these considerations would improve access to HIV testing among MSM in Nigeria.

scholarly journals Effectiveness of a Novel HIV Self-Testing Service with Online Real-Time Counseling Support (HIVST-Online) in Increasing HIV Testing Rate and Repeated HIV Testing among Men Who Have Sex with Men in Hong Kong: Results of a Pilot Implementation Project

2021 ◽  
Vol 18 (2) ◽  
pp. 729
Author(s):  
Paul Shing-fong Chan ◽  
Andrew Chidgey ◽  
Jason Lau ◽  
Mary Ip ◽  
Joseph T.F. Lau ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Real Time ◽  
Linkage To Care ◽  
Standard Of Care ◽  
Multiple Sources ◽  
Self Testing ◽  
Post Test ◽  
Pilot Implementation ◽  
Sex With Men ◽  
Testing Coverage

HIV self-testing (HIVST) with online real-time counseling (HIVST-online) is an evidence-based intervention to increase HIV testing coverage and to ensure linkage to care for men who have sex with men (MSM). A community-based organization (CBO) recruited 122 MSM who had ever used HIVST-online (ever-users) and another 228 new-users from multiple sources and promoted HIVST-online. A free oral fluid-based HIVST kit was sent to all the participants by mail. Experienced HIVST administrators implemented HIVST-online by providing real-time instruction, standard-of-care pre-test and post-test counseling via live-chat application. The number of HIVST-online sessions performed was documented by the administrators. The post-test evaluation was conducted 6 months after the pre-test survey. At month 6, 63.1% of ever-users and 40.4% of new-users received HIVST-online. Taking other types of HIV testing into account, 79.4% of ever-users and 58.6% of new-users being followed up at month 6 received any HIV testing during the project period. Ever-users were more likely to receive HIVST-online and any HIV testing as compared to new-users. Four HIVST-online users were screened to be HIV positive and linked to the treatment. The process evaluation of HIVST-online was positive. Implementation of HIVST-online was helpful to improve HIV testing coverage and repeated HIV testing among Chinese MSM. A larger scale implementation should be considered.

scholarly journals HIV Self-Testing Uptake and Intervention Strategies Among Men in Sub-Saharan Africa: A Systematic Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Akeen Hamilton ◽  
Noah Thompson ◽  
Augustine T. Choko ◽  
Mbuzeleni Hlongwa ◽  
Pauline Jolly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Sex Workers ◽  
Linkage To Care ◽  
Intervention Strategies ◽  
Sub Saharan Africa ◽  
Manual Search ◽  
Self Testing ◽  
Testing Uptake ◽  
Sub Saharan

Background: HIV testing is an essential gateway to HIV prevention and treatment services. However, HIV testing uptake remains low among men due to stigma, discrimination, and confidentiality concerns. HIV self-testing (HIVST) is an alternative HIV testing method that can address many of these barriers for men. We conducted a systematic review to examine HIVST uptake and intervention strategies among Men in Sub-Saharan Africa.Methods: We used a systematic approach to survey literature published from January 2010 to June 2020 using five electronic databases (PubMed-Medline, CINAHL Complete, PsychINFO, Google Scholar, and Web of Science) and a manual search. Studies were included if they were peer-reviewed, published in English, and examined HIVST willingness, uptake, and/or linkage to care and included men in Sub-Saharan Africa.Results: Sixty-three articles related to HIVST were reviewed. Of the included articles, 37 discussed HIVST uptake/acceptability and 24 discussed intervention strategies. Both oral swab and finger-prick methods had high acceptability with ease of access and availability of the test cited as important by men. Free HIVST kits were preferred by men. Secondary distribution of kits via peers, sexual partners, and female sex workers were successful.Conclusion: HIV self-testing is highly acceptable to men. More efforts are needed to develop policies to implement HIVST programs targeting men in Sub-Saharan Africa, including a focus on linkage to care in sub-Saharan Africa. Future interventions should directly target men independently in tandem with using peers and their romantic partners to promote self-testing among men in sub-Saharan Africa. HIVST kit distribution strategies should be combined with services that can offer confirmatory tests and counseling for men as well as linkage to care.

scholarly journals Using individual stated-preferences to optimize HIV self-testing service delivery among men who have sex with men (MSM) in Malaysia: results from a conjoint-based analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Roman Shrestha ◽  
Haridah Alias ◽  
Li P. Wong ◽  
Frederick L. Altice ◽  
Sin H. Lim
Keyword(s):  
Service Delivery ◽  
Hiv Testing ◽  
Online Survey ◽  
Stated Preference ◽  
Relative Importance ◽  
Cross Sectional ◽  
Self Testing ◽  
Telephone Hotline ◽  
Testing Uptake ◽  
Sex With Men

Abstract Background HIV self-testing (HIVST) has the potential to improve HIV testing uptake and frequency for key populations like MSM who experience multiple barriers accessing clinic-based HIV testing. In the absence of HIVST in Malaysia, there is no guidance to inform HIVST delivery. This study investigated the acceptability of HIVST and preferences about the HIVST service delivery approaches using a standardized stated preference method. Methods A cross-sectional online survey conducted between January and April 2019 assessed the interest in HIVST in 544 MSM in Malaysia. Participants ranked eight hypothetical HIVST service delivery program elements with varied combinations of six, two-level HIVST service delivery program attributes (cost, privacy, accuracy, kit collection site, kit type, and testing support). SPSS conjoint procedure was used to estimate the relative importance of each attribute and preference across eight possible HIVST service delivery programs. Results Overall, 70.4% had previously tested for HIV, and of those, 64.0% had done so in the past 6 months (45.0% of all participants). Of all the participants, 25.2% reported having used HIVST previously. The acceptability for HIVST service delivery models ranged from 44.9 to 77.1%, with mean acceptability of 56.2% across the eight hypothetical HIVST distribution scenarios. The HIVST service delivery scenario with the highest acceptability had the following attributes: no cost (free), anonymity (name not required), 99–100% accuracy, home-delivered, fingerstick, and testing support using telephone hotline or texting. HIVST cost was the most important attribute (relative importance score: RIS = 19.30) associated with acceptability, followed by anonymity (RIS = 18.41), accuracy (RIS = 17.33), kit delivery (RIS = 16.99), fingerstick kit (RIS = 15.86), and support (RIS = 12.08). Conclusions Acceptability for HIVST in Malaysian MSM was high but differed markedly by a number of HIVST delivery scenarios and attributes. These findings could be relevant as the Malaysian Ministry of Health is in the process of developing a regulatory framework for ensuring the quality of kits, as well as policies supporting safe use while broader implementation under national AIDS programs.

scholarly journals Perspectives of Policymakers on the Introduction and Scale-Up of HIV Self-Testing and Implication for National HIV Programming in Ghana

2021 ◽  
Vol 9 ◽  
Author(s):  
Henry Nagai ◽  
Henry Tagoe ◽  
Waimar Tun ◽  
Edward Adiibokah ◽  
Augustine Ankomah ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Qualitative Content Analysis ◽  
Scale Up ◽  
National Policy ◽  
Linkage To Care ◽  
Structural Level ◽  
National Guidelines ◽  
Self Testing ◽  
Testing Uptake ◽  
Structural Levels

Background: HIV self-testing (HIVST) has the potential to greatly increase HIV testing uptake, particularly among key populations (KPs) at higher risk for HIV. Studies have shown high acceptability and feasibility of HIVST among various target populations globally. However, less is known about the perspectives of policymakers, who are critical to the success of HIVST implementation. Their views on barriers to the introduction and scale-up of self-testing are critical to understand in order for HIVST to become part of the national HIV guidelines. We sought to understand policymakers' perspectives of challenges and facilitators to the introduction of HIVST at the client and structural levels.Method: Key informant interviews (KIIs) were conducted with national and regional level policymakers involved in the HIV response. Twenty policymakers were purposively selected from Greater Accra (capital) and Brong-Ahafo (outlying) regions. Qualitative content analysis was used to arrive at the results after the verbatim transcripts were coded.Results: Client-level challenges included lack of pre-test counseling, the need for confirmatory testing if reactive, potential for poor linkage to care and treatment, and client-level facilitator from policy makers' perspectives included increase testing modality that would increase testing uptake. Structural-level challenges mentioned by policymakers were lack of a national policy and implementation guidelines on HIVST, cost of HIVST kits, supply chain management of HIVST commodities, data monitoring and reporting of positive cases. The structural-level appeal of HIVST to policymakers were the reduced burden on health system and HIVST's contribution to achieving testing targets. Despite the challenges mentioned, policymakers unanimously favored and called for the introduction of HIVST in Ghana.Conclusions: Findings indicate that a non-conventional HIV testing strategy such as HIVST is highly acceptable to policymakers. However, successful introduction of HIVST hinges on having national guidelines in place and stakeholder consultations to address various individual and structural -level implementation issues.

scholarly journals Perceptions of an HIV self-testing intervention and its potential role in addressing the barriers to HIV testing among at-risk heterosexual men: a qualitative analysis

2021 ◽  
pp. sextrans-2020-054773
Author(s):  
Yi-Roe Tan ◽  
Nashwinder Kaur ◽  
Angeline Jiajun Ye ◽  
Yiwen Zhang ◽  
Jerald Xuan Zheng Lim ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Testing ◽  
Perceived Risk ◽  
Linkage To Care ◽  
Ease Of Use ◽  
Barriers And Facilitators ◽  
Heterosexual Men ◽  
Factors Affecting ◽  
Self Testing ◽  
Post Test

ObjectivesVoluntary HIV testing rates are still low in several Asian countries including Singapore. HIV self-testing (HIVST) has the potential to increase testing, leading to earlier diagnosis and better prognosis. However, the views of at-risk individuals, especially heterosexual men (HSM), who are not coming forward for testing are still poorly understood. In this study, we examined the barriers and facilitators to and delivery preferences for HIVST in order to implement an effective intervention in Singapore.MethodsFrom May 2017 to June 2018, 48 in-depth interviews were conducted with HSM aged 21–66 years and at risk of HIV infection. Participants were purposively sampled based on ethnicity, age and testing behaviour. Recruitment was done mainly at brothels and entertainment establishments in Singapore. Participants gave their views on HIV testing, factors affecting HIVST use and their preferred HIVST service delivery model.ResultsMost participants preferred HIVST over conventional testing for its convenience, privacy, anonymity and autonomy, but older men still preferred conventional testing. Low self-perceived risk, low awareness and self-efficacy for HIVST, and non-comprehensive test for other STIs were reported as barriers to HIVST. There were mixed opinions on kit preference. A blood-based kit was favoured for higher accuracy, while the oral-fluid-based kit was favoured for ease of use. Participants wanted a human touch for post-test counselling and linkage to care only if they self-tested positive. Traditional media, internet and social media, and venue-based outreach were potential advertising platforms mentioned.ConclusionsA locally acceptable and feasible HIVST intervention must address the barriers and facilitators of using HIVST in order to improve HIV testing rates among this at-risk population who might otherwise delay or fail to present for testing.

scholarly journals Drivers and barriers to workplace-based HIV self-testing among high-risk men in Uganda: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patience A. Muwanguzi ◽  
Robert C. Bollinger ◽  
Stuart C. Ray ◽  
LaRon E. Nelson ◽  
Noah Kiwanuka ◽  
...  
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Private Security ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Private Security Companies ◽  
Self Testing ◽  
Key Informant ◽  
Hiv Testing Services ◽  
Security Companies

Abstract Background Men in Sub-Saharan Africa are less engaged than women in accessing HIV testing and treatment and, consequently, experience higher HIV-related mortality. Reaching men with HIV testing services is challenging, thus, increasing the need for innovative ways to engage men with low access and those at higher risk. In this study, we explore men’s perceptions of drivers and barriers of workplace-based HIV self-testing in Uganda. Methods An exploratory study involving men working in private security companies employing more than 50 men in two districts, in central and western Uganda. Focus group discussions and key informant interviews were conducted. Data were analyzed using inductive content analysis. Results Forty-eight (48) men from eight private security companies participated in 5 focus group discussions and 17 key informant interviews. Of the 48 men, 14(29.2%) were ages 26–35 years. The majority 31(64.6%) were security guards. The drivers reported for workplace-based HIV self-testing included convenience, autonomy, positive influence from work colleagues, the need for alternative access for HIV testing services, incentives, and involvement of employers. The barriers reported were the prohibitive cost of HIV tests, stigma, lack of testing support, the fear of discrimination and isolation, and concerns around decreased work productivity in the event of a reactive self-test. Conclusions We recommend the involvement of employers in workplace-based HIV self-testing to encourage participation by employees. There is need for HIV self-testing support both during and after the testing process. Both employers and employees recommend the use of non-monetary incentives, and regular training about HIV self-testing to increase the uptake and acceptability of HIV testing services at the workplace.

scholarly journals Addressing the challenges and relational aspects of index-linked HIV testing for children and adolescents: insights from the B-GAP study in Zimbabwe

2020 ◽  
Author(s):  
Chido Dziva Chikwari ◽  
Sarah Bernays ◽  
Stefanie Dringus ◽  
Victoria Simms ◽  
Helen A Weiss ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Children And Adolescents ◽  
Negative Impact ◽  
Discrete Event ◽  
Routine Care ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Community Based ◽  
Testing Uptake ◽  
Sexual Contacts

Abstract Introduction Index-linked HIV testing, targeted at sexual contacts or children of individuals with HIV, may improve yield and efficiency. The B-GAP study evaluated index-linked testing approaches in health facility and community-based settings. This paper reports on a qualitative study to understand factors that affect uptake of index-linked HIV testing for children and adolescents. Methods We conducted four focus group discussions (FGDs) with caregivers who had their children tested through B-GAP and one FGD with providers who offered index-linked HIV testing to indexes. We aimed to understand enabling and inhibiting factors in the decision-making process. Translated and transcribed transcripts were read for familiarisation. Following initial coding, analytical memos were written to identify emerging key themes across the data. Results Our findings showed there was inadequate emphasis on paediatric HIV in routine care which had a negative impact on subsequent uptake of testing for children. Once the decision to test had been made, access to facilities was sometimes challenging, and alleviated by community-based testing. A key finding was that HIV testing is not a discrete event but a process that was influenced by relationships with other family members and children themselves. These relationships raised complex issues that could prevent or delay the testing process. Conclusion There is a need to improve messaging on the importance of HIV testing for children and adolescents and to provide support to caregivers and their families in order to improve testing uptake. Addressing access barriers through the provision of community-based testing and implementing a family centred approach can optimize index-linked testing.

scholarly journals Uptake of HIV testing and HIV prevalence among men who have sex with men in Karnataka

2019 ◽  
Vol 6 (2) ◽  
pp. 668
Author(s):  
Vani Srinivas ◽  
Rajesh T. Patil ◽  
M. Chandrakantha ◽  
T. L. N. Prasad ◽  
Sunil D. Khaparde
Keyword(s):  
Hiv Testing ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Hiv Prevalence ◽  
Consistent Condom ◽  
Cross Sectional ◽  
Human Immuno Deficiency Virus ◽  
Hiv Test ◽  
Post Test ◽  
Sex With Men

Background: This paper presents the prevalence of human immuno deficiency virus (HIV) infection among men who have sex with men (MSM) attending integrated counselling and testing Centres (ICTC) in selected districts of Karnataka.Methods: A cross sectional study was done at ICTCs. Men and transgenders coming with referral slips from targeted intervention (TI), non-government organizations (NGOs) were considered as MSMs. The basic demographic data, HIV test result and details of post- test counselling were collected in specific format. Data from 13 districts was obtained from April 2009 to March 2010 and comparing the prevalence of HIV among MSM in HIV sentinel surveillance (HSS).Results: Out of 8,276 MSMs in 13 districts, 2808 (33.9%) visited ICTCs with TI NGOs referral slips and were tested for HIV once in a year. The overall prevalence of HIV was 8.6%. Prevalence was highest (17.3%) among men in the age group of 41 to 45 years, illiterates (11.5%), unemployed (11.2%) and divorced and separated (13.3%) and widowed (13.6%) MSMs. Among those tested, 97.7% of MSM underwent post-test counselling and collected their report. The highest HIV prevalence was among MSMs from Mysore district (20.1%), followed by Udupi (19.9%) and Bagalkot (10.6%). Rest of all the other districts had less than 10% of HIV prevalence.Conclusions: The uptake of HIV testing among the MSM with referral slips was low in Karnataka. The prevalence level differs in various districts. There is need for more focused and effective counselling by peer educators for correct and consistent condom usage among illiterate, widowed and unemployed MSMs.

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