Increases in HIV status disclosure and sexual communication between South African men who have sex with men and their partners following use of HIV self-testing kits

Chen, Yea‐Hung; Gilmore, Hailey; Maleke, Kabelo; Lane, Timothy W.; Zuma, Nkosinathi; Radebe, Oscar; Manyuchi, Albert Edgar; McIntyre, James; Lippman, Sheri A.

doi:10.1080/09540121.2020.1828564

Cited by 13 publications

(16 citation statements)

References 25 publications

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“…HIVST could be seen as an opportunity for PLHIV to disclose their status to their partners. Surveys of same-sex couples in China and South Africa found an increase in the disclosure of HIV status with the partner before having sex with each other as a result of access to HIV testing ( 17 , 39 ). However, this finding may be specific to the marital context and the nature and duration of those relationships.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the high level of acceptability of HIVST, there has been little interest in couple testing, particularly among men. Two studies in Malawi and South Africa showed that men usually fear being in a serodiscordant relationship or being judged on their faithfulness ( 17 , 18 ). A study conducted in Uganda among pregnant women showed the feasibility and effectiveness of HIVST secondary distribution to reach their male partners (i.e., giving self-tests to a pregnant woman to distribute to her partner).…”

Section: Introductionmentioning

confidence: 99%

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Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Boye

Bouaré²,

Ky-Zerbo

et al. 2021

Front. Public Health

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Context: The rate of HIV status disclosure to partners is low in Mali, a West African country with a national HIV prevalence of 1.2%. HIV self-testing (HIVST) could increase testing coverage among partners of people living with HIV (PLHIV). The AutoTest-VIH, Libre d'accéder à la connaissance de son Statut (ATLAS) program was launched in West Africa with the objective of distributing nearly half a million HIV self-tests from 2019 to 2021 in Côte d'Ivoire, Mali, and Senegal. The ATLAS program integrates several research activities. This article presents the preliminary results of the qualitative study of the ATLAS program in Mali. This study aims to improve our understanding of the practices, limitations and issues related to the distribution of HIV self-tests to PLHIV so that they can offer the tests to their sexual partners.Methods: This qualitative study was conducted in 2019 in an HIV care clinic in Bamako. It consisted of (i) individual interviews with eight health professionals involved in the distribution of HIV self-tests; (ii) 591 observations of medical consultations, including social service consultations, with PLHIV; (iii) seven observations of peer educator-led PLHIV group discussions. The interviews with health professionals and the observations notes have been subject to content analysis.Results: HIVST was discussed in only 9% of the observed consultations (51/591). When HIVST was discussed, the discussion was almost always initiated by the health professional rather than PLHIV. HIVST was discussed infrequently because, in most of the consultations, it was not appropriate to propose partner HIVST (e.g., when PLHIV were widowed, did not have partners, or had delegated someone to renew their prescriptions). Some PLHIV had not disclosed their HIV status to their partners. Dispensing HIV self-tests was time-consuming, and medical consultations were very short. Three main barriers to HIVST distribution when HIV status had not been disclosed to partners were identified: (1) almost all health professionals avoided offering HIVST to PLHIV when they thought or knew that the PLHIV had not disclosed their HIV status to partners; (2) PLHIV were reluctant to offer HIVST to their partners if they had not disclosed their HIV-positive status to them; (3) there was limited use of strategies to support the disclosure of HIV status.Conclusion: It is essential to strengthen strategies to support the disclosure of HIV+ status. It is necessary to develop a specific approach for the provision of HIV self-tests for the partners of PLHIV by rethinking the involvement of stakeholders. This approach should provide them with training tailored to the issues related to the (non)disclosure of HIV status and gender inequalities, and improving counseling for PLHIV.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Boye

Bouaré²,

Ky-Zerbo

et al. 2021

Front. Public Health

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“…Some studies suggest that access to home HIV testing has helped sexual partners communicate about HIV 32 . Other studies are less sanguine.…”

Section: Information Power and Human Behaviormentioning

confidence: 99%

“…Experts have long warned that the free tests of a research trial and the costly ones on the market are two different entities. 30 When the complete HIV test came to market in 2017, Fortune magazine called its forty-dollar price tag "inexpensive"-for that magazine's readers, perhaps, but hardly so for users in impoverished communities enjoined to test frequently. 31 No insurer covers home tests.…”

Section: The Use Of Home Testing For Contagious Illness Raises Profou...mentioning

confidence: 99%

Public Health at the Kitchen Table: Lessons from the Home HIV Test's Long Road to Approval

Zuger¹

2023

Hastings Center Report

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Home diagnostic testing is becoming part of the modern medical landscape, but many ethical and policy questions remain unresolved. Most of them first surfaced during the long regulatory deliberations over the home HIV test, the first home test for a contagious illness sold in the United States. Between 1989 and 2012, federal regulators and their consultants debated the ideal metrics for such a test, its benefits, and its potential harms for both individuals and communities. Ultimately, two iterations of the home HIV test were marketed in the United States; neither one of them changed the course of the national HIV epidemic, as hoped. This failure has powerful implications for home testing for other contagious diseases.

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“…Of course, this also happened in many countries around the world. Given that most people at risk or high-risk groups, such as men who have sex with men (MSM), female sex workers (FSWs), and transgender people (TGs), may have not even once been diagnosed with HIV, their access to these tests is of great importance [8,13,14]. Many of these key groups may be infected with HIV, but they are unaware of their status, so diagnosing the disease in these people can prevent the transmission of the infection to others.…”

mentioning

confidence: 99%

The Study of Feasibility and Acceptibility of Using HIV Self-Tests in High-Risk Iranian Populations(FSWs, MSM, and TG Populations): A Cross-Sectional Study

Moradi

Amini

Valipour

et al. 2021

Preprint

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Background: This study aimed to evaluate the feasibility of using the HIV Self-Test in high-risk Iranian groups (MSM, FSWs, and TG people).Methods: This study was conducted in 2 main steps (the pre and post HIVST intervention and the qualitative method) between 1 October 2020 and 22 June 2021 in Tehran, Iran. The sample size needed for this study generally was 1000 people, including FSWs, MSM, and transgender individuals. The sampling method in this study was convenience sampling, while snowball sampling was used to complete the number of samples.Results: A total of 930 eligible respondents were enrolled in the study, of whom 456 (49%) were female, 49 (5.3%) were transgender (98% of TGs were male to female). The median age was 33.63 ±10.54 SD. The feasibility of the use of HIV self-tests in Iranian high-risk groups was significantly high. The majority of participants (97%) did not have any confidentiality problems while preparing or performing the test. In general, feasibility was assessed based on five questions. The overall feasibility score was 6.33 (0.824 SD). Taking tests, reading HIV test results, finding a safe place to do the test, and accessing HIV self-testing showed a high average. Conclusion: HIV self-testing was highly acceptable and feasible to permit routine HIV testing between high-risk populations efficiently.

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Increases in HIV status disclosure and sexual communication between South African men who have sex with men and their partners following use of HIV self-testing kits

Cited by 13 publications

References 25 publications

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Challenges of HIV Self-Test Distribution for Index Testing When HIV Status Disclosure Is Low: Preliminary Results of a Qualitative Study in Bamako (Mali) as Part of the ATLAS Project

Public Health at the Kitchen Table: Lessons from the Home HIV Test's Long Road to Approval

The Study of Feasibility and Acceptibility of Using HIV Self-Tests in High-Risk Iranian Populations(FSWs, MSM, and TG Populations): A Cross-Sectional Study

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