HIV self-testing acceptability among injured persons seeking emergency care in Nairobi, Kenya

Abstract

Background Emergency department-based HIV self-testing (ED-HIVST) could increase HIV-testing services to high-risk, under-reached populations. Objectives This study sought to understand the injury patient acceptability of ED-HIVST. Methods Injury patients presenting to the Kenyatta National Hospital Accident and Emergency Department were enrolled from March to May 2021. Likert item data on HIVST assessing domains of general acceptability, personal acceptability, and acceptability to distribute to social and/or sexual networks were collected. Ordinal regression was performed yielding adjusted odds ratios (aOR) to identify characteristics associated with high HIVST acceptability across domains. Results Of 600 participants, 88.7% were male, and the median age was 29. Half reported having primary care providers (PCPs) and 86.2% reported prior HIV testing. For each Likert item, an average of 63.5% of the participants reported they ‘Agree Completely’ with positive statements about ED-HIVST in general, for themselves, and for others. In adjusted analysis for general acceptability, those <25 (aOR = 1.67, 95%CI:1.36–2.08) and with prior HIV testing (aOR = 1.68, 95%CI:1.27–2.21) had greater odds of agreeing completely. For personal acceptability, those with a PCP (aOR = 3.31, 95%CI:2.72–4.03) and prior HIV testing (aOR = 1.83, 95%CI:1.41–2.38) had greater odds of agreeing completely. For distribution acceptability, participants with a PCP (aOR = 2.42, 95%CI:2.01–2.92) and prior HIV testing (aOR = 1.79, 95%CI: 1.38–2.33) had greater odds of agreeing completely. Conclusions ED-HIVST is perceived as highly acceptable, and young people with prior testing and PCPs had significantly greater favourability. These data provide a foundation for ED-HIVST programme development in Kenya.

Implementation and Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) Program in Nairobi, Kenya: A Quasi-Experimental Prospective Study

“…The HEATED program approach is consistent with recommendations for HIV programming for KPs, men and young adults, in improving access to services by meeting persons where they are and reducing gender barriers and stigmatization by utilizing the lens of injury which is not dependent on population identity. 10,12,13 As patient ED-HTS acceptability in sub-Saharan Africa is high, [23][24][25]51,52 further study of how to ensure systems support healthcare providers to best achieve delivery will be beneficial to build from the HEATED program results.…”

“ARVs is for HIV and cream is for HPV or precancer:” Women’s Perceptions and Perceived Acceptability of Self-Administered Topical Therapies for Cervical Precancer Treatment: A Qualitative Study from Kenya

“…As stated in the guideline, these interventions have the capacity to “increase choice and autonomy,” address the global shortage of healthcare workers, and bring us closer to achieving universal health when made “accessible, acceptable and affordable[36]. ” While no studies have evaluated the acceptability of self-administered topical cervical precancer treatment in LMICs, several studies in this setting have demonstrated high acceptability of self-care interventions, including HIV self-testing [37] and the use of vaginal or rectal microbicides for HIV prevention[38], [39]. Similarly, in a study on the acceptability of rectal microbicide for HIV prevention among men who have sex with men in Thailand, ease of use, privacy, and comfort of use at home were facilitators of uptake [40], drawing similarities to our findings.…”