Are women more likely to self-test? A short report from an acceptability study of the HIV self-testing kit in South Africa

Abstract

This study assessed the acceptability of, as well as the facilitators of and barriers to the HIV self-testing kit in the Gauteng province, South Africa. An exploratory qualitative cross-sectional study was conducted using focus group discussions (FGDs) among a sample of 118 respondents selected from the Braamfontein and Soweto areas of Johannesburg. Sixteen FGDs were conducted in order to assess the acceptability of the HIV self-testing kit. Respondent groups were segmented according to area (Soweto or Braamfontein), gender (male or female), age (20-34 and 35-49 years of age) and HIV testing status (have previously tested for HIV or have never tested for HIV) in order to achieve maximum variability. The main advantage identified was that the self-testing kit allows for privacy and confidentiality with regard to HIV status, and does not require a visit to a health facility - two of the main barriers to current HIV counselling and testing uptake. However, respondents, predominantly males, were concerned about the lack of counselling involved, which they thought could lead to suicide ideation among testers. The HIV self-testing kit was found to be acceptable among the majority of respondents. However, there is still a need for follow-up services for self-testers. The idea of a hotline for telephonic counselling within the self-testing model seemed to be favourable among many respondents and is an alternative to traditional face-to-face counselling, although some respondents felt that this was not sufficient.

‘If I had not taken it [HIVST kit] home, my husband would not have come to the facility to test for HIV’: HIV self-testing perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda

“…In a qualitative study by Matovu et al [16], both men and women were concerned that introducing the kits in the home would result in dire consequences for the couple, particularly to the HIV-positive partner in the relationship. These consequences included fears of marital disruption and suicidal ideation [17] due to the absence of pre- or post-test counseling. Similar fears have been documented in other studies [18,19] especially with regard to fears of what could happen in the home in the event that one of the partners is HIV-positive, in the absence of post-test counseling.…”

Quality of counselling and support provided by the South African National AIDS Helpline: Content analysis of mystery client interviews

“…[32] Indeed, many South Africans are familiar with faceto-face counselling after an HIV test, and some evidence suggests a strong preference for this modality, with conversations on the helpline viewed as being insufficient. [12,33] Adding email or online chat to the current services of the helpline may hold several advantages. A Dutch service showed high levels of satisfaction with online mechanisms, which complemented telephonic ones.…”

“…[10] The role of helplines has shifted again with HIV self-testing, where the bulk of post-test counselling for self-testers may take place on helplines. [12] A toll-free HIV helpline was established in 1991 by the South African (SA) National Department of Health in partnership with Lifeline Southern Africa, a non-governmental organisation (NGO) that offers psychological counselling and related services.…”

Perceived Cost Advantages and Disadvantages of Purchasing HIV Self-Testing Kits among Urban Tanzanian Men: An Inductive Content Analysis

“…HIVST is defined as any mode of HIV testing that allows a person to collect his own specimen in private, conduct a rapid antibody test, and be the first person to learn of the results [10,24]. HIVST differs from mobile-and homebased HCTS in that it is not conducted by a trained health care provider [25,26]. The oral fluid HIV self-testing kit has increasingly been piloted in sub-Saharan Africa and found to be feasible and acceptable in countries such as South Africa [25,27], Malawi [23,28,29], Kenya [30,31] and Uganda [32].…”

“…HIVST differs from mobile-and homebased HCTS in that it is not conducted by a trained health care provider [25,26]. The oral fluid HIV self-testing kit has increasingly been piloted in sub-Saharan Africa and found to be feasible and acceptable in countries such as South Africa [25,27], Malawi [23,28,29], Kenya [30,31] and Uganda [32]. Several African ministries of health have also removed legislative bans on the sale of HIVST kits [27,33] and developed policy guidelines for HIVST in the general public [30,34].…”