HIV self-testing implementation, distribution and use among female sex workers in Cotonou, Benin: a qualitative evaluation of acceptability and feasibility

Moreau, Marianne Boisvert; Kintin, Frédéric; Atchekpe, Septime; Batona, Georges; Béhanzin, Luc; Gagnon, Marie‐Pierre; Alary, Michel

doi:10.1186/s12889-022-12917-3

Cited by 4 publications

(10 citation statements)

References 45 publications

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“…Our findings are consistent with many studies conducted in several contexts, which have shown that difficulties in performing HIV testing are particularly related to low levels of education [13,[26][27][28], particularly among FSW [29,30].…”

Section: Discussionsupporting

confidence: 92%

“…Participants' low level of knowledge was expected since HIVST is a relatively new screening method that is not yet available in the country. That low awareness of HIVST is also consistent with results from other studies conducted in low and middleincome countries [13].…”

Section: Discussionsupporting

confidence: 91%

“…On a regional scale, UNITAID has set up two major projects, "ATLAS "and "STAR", aiming to introduce, promote and expand HIV self-testing in Africa [11,12]. Several recent studies conducted in sub-Saharan Africa have demonstrated high acceptability and uptake of HIVST such as in Benin [13], Uganda [14,15], Nigeria [16], Malawi [17], Kenya [18], and Rwanda [19].…”

Section: Introductionmentioning

confidence: 99%

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Acceptability and usability of oral fluid-based HIV self-testing among female sex workers and men who have sex with men in Morocco

Moussa¹,

Belhiba²,

Hajouji³

et al. 2022

BMC Public Health

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Background In 2020, almost 20% of people living with HIV (PLHIV) in Morocco are still unaware of their HIV status. Under these circumstances, HIV self-test (HIVST) can be an efficient additional tool for improving the testing rates in Morocco and reaching the first objective of the UNAIDS 95–95-95 goal. ALCS, a Community-based organization, involved in HIV Testing since 1992, and the Ministry of Health of Morocco conducted, a study on the acceptability and usability of HIVST among Female sex workers (FSW) and MSM (men who have sex with men), using a salivary rapid test. To our knowledge, this is the first study in Morocco exploring these parameters. Methods We conducted a pilot study on the usability of the OraQuick HIV-1/2 salivary self-test among MSM and FSW visiting the ALCS centers for standard HIV rapid testing in five Moroccan cities. Participants chose whether or not to be assisted by lay provider HIV testing. The counselors sampled them to perform a standard rapid test and then invited them to a private room to perform the HIV self-test simultaneously. In addition, a questionnaire was administered to collect socio-demographic data and to assess their opinion about the usability of the salivary HIVST. Results Our study was carried out for 5 months and included 492 participants (257 MSM and 233 FSW). The average age of the participants was 29 years among MSM vs 34 years among FSW. The FSW have a lower educational level, 28,8% of them are Illiterate vs. 6,1% of the MSM. Only 18% of participants were aware of the existence of the HIVST, nevertheless, we recorded a very high rate of acceptability (90,6%) of the HIVST. Performing the HIVST was deemed very easy for 92,2% of MSM versus 80,6% of FSW. Although it was found very difficult for six participants, including five FSW, 4 of them could not read or write. Overall, the study registered a high HIV positivity rate (3,8%) and 100% of concordance between HIVST participants’ interpretation and standard HIV testing performed by ALCS lay provider HIV testing. Conclusion Our study shows very high acceptability of HIVST among FSWs and MSM in Morocco, HIV self-testing is still unknown by key populations in Morocco, and the low level of education of FSWs may be a barrier to the use of this test, but with the proposed assistance and adapted demonstration tools, the HIV self-testing will certainly improve access to testing in Morocco.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Acceptability and usability of oral fluid-based HIV self-testing among female sex workers and men who have sex with men in Morocco

Moussa¹,

Belhiba²,

Hajouji³

et al. 2022

BMC Public Health

View full text Add to dashboard Cite

show abstract

“…Other facilitators to HIVST revealed in this review were, ease of use, (Agot et al, 2022;Boisvert Moreau et al, 2022). However, this is largely noted to be among literate than illiterate clients.…”

Section: Discussionmentioning

confidence: 80%

“…In a study understanding factors that promote uptake of HIV self-testing among young people in Nigeria, (Mason et al, 2022) the youth indicated to lack knowledge or awareness around HIV and HIVST. Similarly in Benin, (Boisvert Moreau et al, 2022) found that only 6.9% FSWs had heard of HIVST.…”

Section: Lack Of Knowledge Of the Existence Of Hivstmentioning

confidence: 94%

Barriers and Facilitators of HIV Self-Testing in Africa: A Qualitative Systematic Review

Samidu,

Chisoni,

Umar

2023

Preprint

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Background: HIV self-testing (HIVST) is an innovative approach that has the potential to improve HIV testing uptake and linkage to care for those who test positive. In this systematic review, we explored barriers and facilitators to HIVST uptake for various populations in Africa. Methodology: We systematically searched multiple electronic databases for relevant English-language articles published between January 2015 and February 2023. The databases included PubMed, Cumulative Index for Nursing and Allied Health Professions Literature (CINAHL), Embase, and Scopus for qualitative research articles on HIVST from different African countries. Findings: A total of 313 articles were identified through a literature search, and 11 met the inclusion criteria. This review shows that HIVST is a highly acceptable method of HIV testing among various populations. Perceived facilitators of the uptake of HIVST were convenience, autonomy and self-empowerment, privacy, confidentiality, and ease of use. The perceived barriers included the cost of self-test kits, perceived unreliability of test results, low literacy, fear and anxiety of a positive test result, potential psychological and social harms, and a lack of linkage to care. Conclusion: This review observes that the establishment of innovative approaches such as mobile phone counselling to support pre- and post-test care for those seeking HIVST is critical for the successful scaling up of this intervention. Furthermore, for resource-poor contexts, affordable HIVST is essential to ensure the absorption of the same.

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A community-based study of intention to use HIV self-testing among young people in urban areas of southern Ethiopia

Zeleke,

Stephens,

Gesesew

et al. 2024

Sci Rep

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In sub-Saharan Africa, young people are at high risk of HIV infection, representing nearly 4 out of 5 new infections. HIV self-testing (HIVST), a new and proactive testing scheme that involves self-collection of a specimen and interpretation of results, is deemed potentially helpful for increasing testing amongst population groups like young people who do not frequently use routine testing services. This study assessed young people’s intention to use HIVST in urban areas of southern Ethiopia drawing on the Theory of Planned Behaviour. A community-based cross-sectional study was conducted with 634 participants aged 15–24 years from six town administrations of two zones in January to February 2023. The participation rate was 634/636 yielding 99.7%. The OraQuick HIVST kit was demonstrated to young people recruited in a door-to-door survey with a face-to-face interview using an electronic questionnaire in a mobile phone-based application. Intention to use HIVST was measured from a 6-point Likert scale with scores of agreements ranging from 1 to 6. Descriptive statistics and ordinal logistic regression analysis were done using STATA version 18. Most of the participants agreed that they would use HIVST if it was available (86.3% agreeing or strongly agreeing). Interestingly, young people who perceived themselves at some to high risk were 0.51 times less likely to be in the higher order of intention to use when HIVST is available to them than those who perceived themselves at no to low risk. Intention to use HIVST increased by a factor of 1.29, 1.84 and 2.35 for every one-unit increase on the mean favourable attitude, perceived behavioural control, and acceptability scores, respectively. The majority of young people intended to use HIVST. Young people’s perceived behavioural control, and acceptability of HIVST affected their intention to use. Intention and subsequent use of HIVST can be enhanced through an understanding of the role of risk perception and positive attitude, confidence to perform and acceptance of the test. Implementation studies are required to examine the actual uptake of HIVST among young people. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-77728-5.

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HIV self-testing implementation, distribution and use among female sex workers in Cotonou, Benin: a qualitative evaluation of acceptability and feasibility

Cited by 4 publications

References 45 publications

Acceptability and usability of oral fluid-based HIV self-testing among female sex workers and men who have sex with men in Morocco

Acceptability and usability of oral fluid-based HIV self-testing among female sex workers and men who have sex with men in Morocco

Barriers and Facilitators of HIV Self-Testing in Africa: A Qualitative Systematic Review

A community-based study of intention to use HIV self-testing among young people in urban areas of southern Ethiopia

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