Acceptability of HIV Self-Testing in Sub-Saharan Africa: Scoping Study

Harichund, Charlene; Moshabela, Mosa

doi:10.1007/s10461-017-1848-9

Cited by 111 publications

(118 citation statements)

References 50 publications

(144 reference statements)

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“…While several studies have documented the high acceptance of HIVST among populations [16,[38][39][40] and its convenience [41,42], this, to our knowledge, is the first systematic review and meta-synthesis to assess men's perspectives on HIVST in SSA. While education is key to changing men's perspectives and improving HIV knowledge, this study further revealed that HIV self-testing is critical to addressing issues of confidentiality and convenience [9,16,43,44].…”

Section: Discussionmentioning

confidence: 98%

Men’s perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis

et al. 2020

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Background: Despite the many HIV testing models implemented in Africa, the level of HIV testing uptake remains relatively poor, especially among men. The HIV self-testing (HIVST) model offers an additional approach for encouraging men to get tested. This study aimed to synthesise evidence on men's perspectives regarding HIVST in sub-Saharan Africa (SSA). Methods: The databases searched included PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host; Union Catalogue of Theses and Dissertations; SA ePublications via SABINET Online; World Cat Dissertations; Theses via OCLC; ERIC; CINAH; PsychInfo; Embase, Sociological Abstract, Scopus; and Google Scholar. The World Health Organization (WHO) and The Joint United Nations' Programme on HIV and AIDS (UNAIDS) websites were further searched. We only extracted qualitative information from the included studies, despite the research method used (qualitative or mixed methods). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), as well as the Mixed Method Appraisal Tool (MMAT) version 2018, were used to determine the methodological quality of the included studies. NVivo version 11 was used for thematic analysis. Results: A total of 21,184 articles were identified by the initial search criteria, but only 16 articles were included in the data extraction and quality assessment stage. The following key themes emerged: knowledge of HIVST; acceptability of HIVST; need for HIVST counselling; confidentiality of HIVST; convenience of HIVST; and accuracy of HIVST. The study shows that while HIVST provides men with an alternative, confidential and convenient testing model, the potential for psychological and physical harm remains a challenge. Conclusion: The introduction of the HIVST strategy has the potential of improving men's uptake in HIV testing services, thereby contributing towards addressing the first cascade of the 90-90-90 strategy. While HIVST has a potential for addressing men's barriers to attending clinic settings, such as confidentiality and convenience, it barely addresses the HIVST counselling and accuracy concerns.

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Section: Discussionmentioning

confidence: 98%

Men’s perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis

et al. 2020

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“…In addition, many testers desire in-person support during the test process [9] or need encouragement and reassurance from those providing pre-test counselling in order to proceed with testing [4]. The current data around HIVST is growing, but still inadequate from sub-Saharan African countries when considering the burden and distribution of HIV, and research regarding appropriate counselling services and implementation of HIVST is needed [14]. In addition, previous qualitative research suggests further exploration of counselling provision during HIVST is necessary, specifically within South Africa [15].…”

Section: Introductionmentioning

confidence: 99%

Alone But Supported: A Qualitative Study of an HIV Self-testing App in an Observational Cohort Study in South Africa

et al. 2019

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HIV self-testing has the potential to improve test access and uptake, but concerns remain regarding counselling and support during and after HIV self-testing. We investigated an oral HIV self-testing strategy together with a mobile phone/tablet application to see if and how it provided counselling and support, and how it might impact test access. This ethnographic study was nested within an ongoing observational cohort study in Cape Town, South Africa. Qualitative data was collected from study participants and study staff using 33 semi-structured interviews, one focus group discussion, and observation notes. The app provided information and guidance while also addressing privacy concerns. The flexibility and support provided by the strategy gave participants more control in choosing whom they included during testing. Accessibility concerns included smartphone access and usability issues for older and rural users. The adaptable access and support of this strategy could aid in expanding test access in South Africa. ResumenEl autotest del VIH puede mejorar su acceso y uso, pero, existe inquietud sobre el asesoramiento y apoyo al paciente durante y después del autotest. Investigamos una estrategia de autotest oral con una aplicación para teléfono/tableta para observar cómo proporcionaría asesoramiento y apoyo, e influenciaría el acceso al test. Este estudio etnográfico fue anidado en un estudio de cohorte observacional en curso en Ciudad del Cabo, Sudáfrica. Recogimos datos cualitativos de participantes y personal del estudio empleando 33 entrevistas semiestructuradas, una discusión de grupo focal, y apuntes de observación. La aplicación proporcionó información y orientación, abordando inquietudes sobre privacidad. La flexibilidad y apoyo al paciente proporcionaron a los participantes más control sobre quién involucraban en el test. Problemas de accesibilidad incluyeron acceso y uso de Smartphone en usuarios mayores y residentes rurales. El acceso adaptable y apoyo de esta estrategia podría ayudar a expandir el acceso al test en Sudáfrica.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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“…While multiple studies have been conducted to understand the acceptability of HIVST [35][36][37], but none are from Tanzania. This study sought to explore the acceptability of HIVST among FSWs to inform the formulation of programmatic approaches in delivering HTS to FSWs in Tanzania.…”

Section: Introductionmentioning

confidence: 99%

Female sex workers perspectives and concerns regarding HIV self-testing: An exploratory study in Tanzania

Nnko

Nyato

Kuringe

et al. 2019

Preprint

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Background: HIV testing is a gateway to HIV care and treatment for those testing positive and can link those with negative results to HIV preventive services. Despite the importance of HIV testing services (HTS) in HIV control, uptake of HTS among female sex workers (FSWs) across sub-Saharan Africa (SSA) remains sub optimal. Concerns about stigma associated with sex work and fear of loss of livelihood if HIV status becomes known, are some of the restrictions for FSWs to utilize HTS offered through health care facilities. Introduction of HIV self-testing (HIVST) may mitigate some of the barriers for the uptake of HTS. This study explored perspectives of FSWs towards HIVST in Tanzania.Methods: We conducted an exploratory study employing in-depth interviews (IDI) and participatory group discussions (PGD) with FSWs in selected regions of Tanzania. Study participants were recruited through snowball sampling. Data were thematically analysed by two analysts using NVivo software.Emerging themes were explored in the tradition of Grounded Theory. The analysis was informed by the social ecological model and focused on factors associated with the feasibility of scaling up HIVST.Results: A total of 23 PGD sessions were conducted involving 227 FSWs. Data from PGDs were complemented by 21 IDI. FSWs were enthusiastic toward HIVST. Convenience (time and cost saved), and belief that HIVST will increase privacy and confidentiality motivated participants' support for the self-testing approach. Participants did express concerns about their ability to interpret and trust the results of the test. Participants also expressed concern that HIVST could cause personal harm, including severe distress and self-harm for individuals with reactive test. This was linked to the study participants' perception that HIVST would be provided only through unassisted modality.Conclusions: FSWs demonstrated high enthusiasm to use the HIVST once it becomes available.Increased confidentiality, reduced opportunity costs, and increased autonomy were among the key factors for the intended use of HIVST. Major concerns included fear of HIV reactive test and not trusting self-diagnoses. Our findings underscore the importance of providing adequate access to counselling and referral services in conjunction with HIVST.

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Acceptability of HIV Self-Testing in Sub-Saharan Africa: Scoping Study

Cited by 111 publications

References 50 publications

Men’s perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis

Men’s perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis

Alone But Supported: A Qualitative Study of an HIV Self-testing App in an Observational Cohort Study in South Africa

Female sex workers perspectives and concerns regarding HIV self-testing: An exploratory study in Tanzania

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