Barriers and enablers toHIV self testing in the private sector among sexually active females and males in Kenya, Uganda, and Nigeria: findings from qualitative market research

Title

Barriers and enablers toHIV self testing in the private sector among sexually active females and males in Kenya, Uganda, and Nigeria: findings from qualitative market research

Presenter

Serah Malaba

Authors

S. Malaba * (1), K. Hatzold (2), C. Pahe (3), W. Adamba (3), B. Wango (3), I. Nzuki (3), G. Omoregie (4), D. Aizobu (4), B. Adesina (4), P. Omodele (4), B. Abdullahi (4), D. Ukaga (4), P. Buyungo (5), M. Luyiga (5), B. Lukwago (5), D. Nakimuli (5), J. Oriokot (5), M. Mugambi (6), A. Ikpeazu (7), G. Taasi (8), T. Chimulwa (8)

Institutions

(1) Population Services International, HIV/TB, Nairobi, Kenya, (2) Population Services International, HIV/TB, Cape Town, South Africa, (3) Population Services Kenya, HIV, Nairobi, Kenya, (4) Society for Family Health, HIV, Abuja, Nigeria, (5) Population Services International, HIV/TB, Kampala, Uganda, (6) Ministry of Health, Kenya, NASCOP, Nairobi, Kenya, (7) Nigeria Federal Ministry of Health, Nigeria Federal Ministry of Health, Lagos, Nigeria, (8) Ministry of Health, Uganda, Ministry of Health, Uganda, Kampala, Uganda

BACKGROUND: HIV self-testing (HIVST) has been proven to be effective in increasing demand for HIV testing among populations that are at risk of HIV acquisition. While HIVST products are penetrating the market in many countries, there are unanswered questions on how to develop consumer demand and how to ensure linkage into care, treatment, and prevention post HIVST. We conducted qualitative research to understand the enablers and barriers to uptake, use, post-test linkage and results reporting among current and potential users of HIVST in the private sector.
METHODS: 104 In-depth interviews (IDIs) and 15 group discussions (FGDs) were conducted among sexually active males and females of 18 ' 29 years. Purposive sampling was used to enroll sexually active males (89) and females (95) into the study. Research was carried out July ' September 2021 in Kenya, Nigeria, and Uganda. Thematic analysis was used to analyze and code the data using NVivo. We analyzed patterns of themes within the data and identified enablers and barriers to HIVST uptake, use, post-test linkage and results reporting.
RESULTS: Respondents identified key enablers including social media advertising as a key source of information on HIVST. Bundling of HIVST kits with other products eased the purchasing moment.. Users had confidence in the efficacy of HIVST which made them trust the test results. The implications of a reactive results influenced users to link into confirmatory testing. Users suggested they were willing to report their results to strengthen HIV programs and research. Respondents cited the following key barriers: fear of a reactive result which made HIVST unattractive to non-users, lack of awareness that the kits were sold in pharmacies and concerns of user errors which resulted in the lack of confidence to self-test. Participants recounted delays in linking into confirmatory testing following the shock of a reactive result. Lack of information on how to report HIVST and concerns over data privacy were cited as key hinderances to reporting.
CONCLUSIONS: These results provide the basis for co designing interventions that will support HIVST users complete the HIVST journey in terms of purchase, use, post-test linkage and results reporting.

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