Co-creation of HIVST delivery approaches for improving urban men’s engagement with HIV services in eThekwini District, KwaZulu-Natal: nominal group technique in intervention development

Abstract

Background HIV self-testing (HIVST) is one of the recommended approaches for HIV testing services, particularly for helping reach populations who would not normally access facility-based HIV testing. Key stakeholder engagement is paramount in tailoring health interventions to ensure uptake by target populations. Objective The main objective of this study was to collaborate with key stakeholder in the co-creation of an acceptable HIVST delivery strategies to help improve urban men’s engagement with HIV services. Methods We invited key stakeholders for urban men’s HIV services to participate in a co-creation workshop aimed at developing HIVST delivery approaches for urban men, using eThekwini municipality as a study setting. We conducted purposive sampling to include health care users and health care providers, representing a range of views across the public sector and voluntary sector. We employed the nominal group technique (NGT) method for data collection. The NGT workshop was conducted in two consecutives: phase 1 was focused on determining barriers for men’s engagement with the current/facility-based HIV testing services; phase 2 was aimed at determining HIVST delivery strategies. Results Participants identified the following factors as the most important barriers to uptake of HIV testing services by urban men: stigma, ignorance about the importance of testing, and testing process as well as fear of positive test results. Key stakeholders suggested internal motivation strategies as a potentially effective approach to support HIVST delivery strategy. Guided by the NGT results, we designed a HIVST delivery strategy that is supported by a risk communication approach. Conclusion The NGT enabled successful collaboration with key stakeholders in the co-creation of HIVST delivery strategies to guide implementation and strategy improve urban men’s engagement with HIV services. A follow-up study to evaluate the feasibility of implementing these approaches is recommended.

Community engagement tools in HIV/STI prevention research

“…The main actors include but not limited to individuals from the target community, community leaders, religious leaders, community workers, policymakers, healthcare providers, researchers and many others involved in the decision-making process. These approaches can be roughly categorized into in-depth interviews or focus group discussions for formative research [12,13], short-term consultation with community members (often referred as community advisory board) for study design, implementation and results dissemination [14,15], and co-creation of intervention strategies or components with a small number of community members [16 ▪ ]. While this type of community engagement may involve a wide range of stakeholders in the research decision-making process, the main difference between individual-level and community-level engagement is the duration and extent of such engaging efforts.…”

“…At the individual-level engagement, community partners typically function as occasional consultants, offering their insights in a one-time capacity or primarily participating during the preliminary phases of a research project. A typical example is a South Africa-based study [16 ▪ ] that employed two workshops to allow researchers and key stakeholders to co-develop HIV self-testing delivery strategies by joint problem identification and intervention development.…”