Acceptability of HIV Oral Self-Test Among Men Having Sex With Men and Transgender Population: A Qualitative Investigation From Pune, India

Rao, Amrita; Patil, Shashikant; Aheibam, Sharmila; Kshirsagar, Prajkta; Hemade, Pranoti; Panda, Samiran

doi:10.1177/1178633720962809

Cited by 16 publications

(14 citation statements)

References 19 publications

(30 reference statements)

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“…The participants in the current study reported some apprehensions around HIVOST such as accuracy of the results, disposal of kits, and self-harm. These findings were similar to the concerns raised by the MSM and TG populations around in Pune, Maharashtra in India [ 33 ].…”

Section: Discussionsupporting

confidence: 89%

Acceptability of HIV oral self-test among truck drivers and youths: a qualitative investigation from Pune, Maharashtra

et al. 2021

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Background Ending AIDS by 2030 is a global target, to which India is a signatory. HIV-self-test (HIVST) coupled with counselling and AIDS-care, including antiretroviral therapy, has the potential to achieve this. However, national programs are at varying stages of acceptance of HIVST, as discussions around its introduction spark controversy and debates. HIV-self-test, as yet, is not part of the AIDS control program in India. Against this backdrop, we explored acceptability of an HIV oral self-test (HIVOST) among truckers and young men and women. Methods A qualitative investigation with 41 in-depth-interviews and 15 group discussions were conducted in the district of Pune, in the western state of Maharashtra, India. These interactions were built around a prototype HIVOST kit, helped in taking the discussions forward. The software N-vivo (version 11.0) was used to manage the volumes of data generated through the aforementioned process. The study was conducted during June through December, 2019. Results While the truckers belonged to the age bracket 21–67 year, the youths were in the age group 18–24 year. ‘Ease of doing HIVOST’ and ‘fear of needle pricks’ were the reasons behind acceptance around HIVOST by both the study groups. Truckers felt that HIVOST would encourage one to know one’s HIV status and seek help as appropriate. Accuracy of HIVOST result and disposal of the kits following use were concerns of a few. Most of the participants preferred saliva over blood as the specimen of choice. Instructions in local language reportedly would enable test-use by self. The truck drivers preferred undertaking HIVOST at the truckers-friendly ‘Khushi clinics’ or in the vehicle, while youths preferred the privacy of home. Some of the young men mis-perceived the utility of HIVOST by referring to doing a test on a partner immediately prior to sexual encounter. On the other hand, a few truckers had wrong information on HIV cure. Conclusions Overall, the study communities expressed their acceptance towards HIV-self-test. The National AIDS Control Program, India would benefit by drawing upon the findings of the current investigation. Existing myths and misconceptions around HIV test and treatment require program attention.

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Section: Discussionsupporting

confidence: 89%

Acceptability of HIV oral self-test among truck drivers and youths: a qualitative investigation from Pune, Maharashtra

et al. 2021

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“…HIVST doubles HIV testing rates, causes no greater social harm than clinic-based testing, and remains associated with reduced risky sexual behavior among MSM (17,20). While previous HIVST studies largely focused on high-income countries (18)(19)(20) recent evidence shows improved testing coverage within low-to-middle income countries, including in SSA (20)(21)(22)(23)(24)(25)(26)(27). WHO guidelines highlight the importance of engaging community members in creating and delivering HIVST initiatives (17).…”

Section: Introductionmentioning

confidence: 99%

Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men – Lessons From Ghana, West Africa

Abubakari

Turner

et al. 2021

Front. Public Health

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MSM in Ghana encounter challenges in accessing HIV services and may experience barriers to HIV self-testing due to multiple forms of stigma present in health care settings. We worked with community-based organization partners to implement three interventions that successfully engaged and retained MSM which provides an opportunity for linkage to self-testing and medical care. These interventions were (1) Many Men Many Voices (3MV) a locally-led culturally grounded group-level HIV prevention program, (2) Auntie's Corner: a mobile-app based connecting MSM to health monitoring by a registered nurse and (3) HIV Education, Empathy, & Empowerment (HIVE3): a mobile-app based peer support intervention for MSM living with HIV. The 3MV intervention may be effective in improving HIV self-testing due to its effectiveness in engaging MSM, increasing HIV testing, and improving MSM understanding of the need for HIV testing. The utilization of apps like Auntie's Corner could positively impact HIV self-testing among MSM because it increases contact with nurses and reporting of symptoms. In HIVE3, participants expressed appreciation of the security and privacy that protects their identities as MSM and the peer mentors' abilities to make referrals to the nurses in Auntie's Corners. The confidentiality component has proven key among MSM and connecting MSM to self-testing through apps to report their process and receive care could increase utilization. Together, we show the efficacy of using the community-engaged process in reaching and engaging highly stigmatized populations like Ghana and sub-Saharan Africa, and its potential in increasing HIV self-testing and linkage to HIV care.

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“…In our study, we focused on the effectiveness of oral HIVST kits only among MSM. Evidence has shown that oral HIVST kits are less painful than finger-prick HIVST kits and are more acceptable to KPs for HIV testing [23,24]. We also included the latest evidence in the literature on oral HIVST.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Comparing the Effects of Oral HIV Self-Testing With Those of Standard HIV Testing for Men Who Have Sex With Men (MSM): A Systematic Review and Meta-Analysis

Vashisht¹,

Jha²,

Thakur³

et al. 2022

Cureus

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The WHO recommends HIV self-testing (HIVST) as an innovative strategy and an additional testing approach to attain UNAIDS targets to end HIV by 2030. HIVST is a process whereby a person collects his or her own specimen (either oral fluid or blood), performs an HIV test, and interprets the result. It has been described as a discreet and convenient way to reach the hidden, unreached key populations (KPs) who do not know their HIV status or do not get tested. Among the KPs, men who have sex with men (MSM) is one such group that by far remains hidden due to feared stigma and discrimination associated both with their sexuality and HIV. Fear of pain and blood while HIV testing also deters MSM from getting tested. In this review, we assessed the effect of oral HIVST on the uptake and frequency of testing and risk behavior as compared to standard HIV testing.For this review, we systematically searched various electronic databases for clinical trials comparing HIVST to standard HIV testing from January 1, 2011, to December 31, 2021. A meta-analysis of studies was conducted using a random-effects model for relative risks (RRs) and 95% confidence intervals (CIs). The protocol was registered with PROSPERO, and PRISMA guidelines for systematic reviews and meta-analyses were followed. The quality of the clinical trials was assessed using Cochrane's risk of bias tool version 2.0 (RoB 2.0).We identified eight studies comparing HIVST to standard HIV testing services (HTSs). The eight randomized controlled trials (RCTs) enrolled 5,297 participants, of which 5,212 were MSM and 85 were transgender (TG) women. Seven RCTs were conducted in high-income countries (HICs): four in the USA, two in Australia, and one in Hong Kong. One was conducted in a low-middle-income country (LMIC) in Myanmar. In all the studies, HIVST intervention was provided with oral HIVST kits, except for one study in which both bloodbased and oral HIVST kits were used. Meta-analysis (five RCTs) showed that HIVST increased the uptake of HIV testing by 1.43 times compared to standard of care (SoC) (RR = 1.43; 95% CI = 1.25, 1.64). Meta-analysis (four RCTs) found that HIVST increased the mean number of HIV tests by 2.34 during follow-up (mean difference = 2.34; 95% CI = 1.66, 3.02). Meta-analysis (four RCTs) showed that HIVST doubled the detection of new HIV infections among those tested (RR = 2.10; 95% CI = 1.35, 3.28) and reported higher repeat testing as compared to the control arm (RR = 2.04; 95% CI = 1.22, 3.42). A meta-analysis of three trials found no significant difference in risk behavior in respect of condomless anal intercourse (CAI) (odds ratio (OR) = 0.90; 95% CI = 0.67, 1.22) and multiple male partnership (RR = 0.89; 95% CI = 0.83, 0.94).Oral HIVST could increase the HIV testing and detection of new HIV infections among MSM who may not otherwise test, as compared to standard testing services alone. However, further research from low-middleincome countries is required for generalizability.

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Acceptability of HIV Oral Self-Test Among Men Having Sex With Men and Transgender Population: A Qualitative Investigation From Pune, India

Cited by 16 publications

References 19 publications

Acceptability of HIV oral self-test among truck drivers and youths: a qualitative investigation from Pune, Maharashtra

Acceptability of HIV oral self-test among truck drivers and youths: a qualitative investigation from Pune, Maharashtra

Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men – Lessons From Ghana, West Africa

Comparing the Effects of Oral HIV Self-Testing With Those of Standard HIV Testing for Men Who Have Sex With Men (MSM): A Systematic Review and Meta-Analysis

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