Mate Yako Afya Yako: Formative research to develop the Tanzania HIV self-testing education and promotion (Tanzania STEP) project for men

Abstract

The purpose of this formative research, guided by the Integrated Behavioral Model, was to assess men’s attitudes and personal agency towards HIV self-testing (HIVST) and confirmatory HIV testing in order to inform the development of the Tanzania STEP (Self-Testing Education and Promotion) Project, a peer-based HIV self-testing intervention for young men in Tanzania. Qualitative in-depth interviews were conducted with 23 men in Dar es Salaam, Tanzania who socialize in networks locally referred to as “camps”. Men reported privacy, confidentiality, and saving time as the primary reasons for their self-testing interest. Most participants had high perceived control and self-efficacy to self-test and seek confirmatory HIV testing. Nevertheless, men reported concerns related to their ability to perform the test and the potential lack of post-test counseling. Specific recommendations for the intervention included providing HIVST education and pre-test counseling, and using mobile health (mHealth) strategies for participants to reach a healthcare professional for further assistance. The findings suggest that while HIVST is highly acceptable among men in Tanzania, future interventions will need to address the challenges that men may face with HIVST before promoting it as an alternative or supplement to facility-based HIV testing.

Feasibility of an HIV self-testing intervention: a formative qualitative study among individuals, community leaders, and HIV testing experts in northern Tanzania

“…Positive attitudes towards HIVST were primarily related to enjoying the freedom to test for HIV in the privacy and at a convenient place of their choice, and relief to avoid needle pricks for using the oral-fluid sample, which is a less invasive and painless procedure. These findings are in line with studies done in other settings [44][45][46]. Thus, we expect that future HIVST intervention using oral-fluid samples among FBWs and MCPs is more likely to be accepted in Northern Tanzania.…”

“…Our results showed mixed findings on the participant's confidence in their capacity to use the HIVST. Interestingly, men compared to women, reported high confidence in using HIVST correctly after face-to-face counseling with a trained counselor, parallel to findings from a study conducted in Tanzania [46]. However, female participants expressed a lack of confidence in using HIVST in privacy, underscoring the importance of self-efficacy influence on an individual's confidence in their ability to perform a new technology [56,71].…”

Adaptation of a Health Education Program for Improving the Uptake of HIV Self-Testing by Men in Rwanda: A Study Protocol

“…Several studies have called for the need for the implementation of policies that advocate for men's health [49][50][51]. Tailored HEPs to improve men's uptake of HTSs have been recommended [52]. As HIVST is relatively new in Rwanda [11], there is need for the implementation of guidelines and policies that advocate for men's engagement in this new intervention and for the scaling up thereof [53].…”

Health education programs for improving men’s engagement with health services in low- to middle-income countries: a scoping review protocol

“…Evidence shows that males in low-to middle-income countries (LMICs) are not accessing health services as much as their female counterparts resulting in worse outcomes which include mortality [1,2,8]. Health education programs (HEPs) have been recommended to address poor health seeking behavior among key populations including men [9,10]. HEPs are a form of health promotion through health literacy and are immensely beneficial in keeping people alive by providing valued services to populations, information on combating various diseases and promoting health awareness [11].…”

“…Ensuring healthy lives and promoting well-being for all at all ages is one of the key agendas adopted by the UN General Assembly for 2030 [12]. Gender-specific strategies for care delivery, health education, and research are key to achieving these goals, particularly in disease-burdened LMICs [9,[13][14][15]. A 2007 World Health Organization (WHO) review of interventions designed to involve men and boys in achieving gender equality and better health concluded that well-designed male involvement interventions would be more effective at improving men's attitudes and behaviors toward sexual and reproductive health and other health conditions [16].…”