HIV self-testing in Pune, India: perspectives and recommendations of female sex workers and peer educators

Chang, Yanni M; Sevekari, Tejaswi; Duerr, Ann; Molina, Yamilé; Gilada, Trupti

doi:10.1080/09540121.2019.1683804

Cited by 9 publications

(8 citation statements)

References 14 publications

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“…Another qualitative study, conducted a few years ago in the brothels of Pune, revealed positive attitude of female sex workers towards HIV self-test. 20 While the latter investigation involved HIV sero-reactive and non-reactive peer educators and FSWs, to whom the concept of self-test was verbally explained, the uniqueness of the present study rested with an HIV oral self-test kit, which was placed in front of the participants to facilitate interviews and discussions around it. It is important to note that some low and middle income countries like Peru and Brazil have also recorded high acceptability of HIV self test among MSM and TG population groups.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Globally HIV-self-test is considered as an important tool to end AIDS. However, several countries, including India, are yet to adopt such a strategy. Against this background, we conducted a qualitative inquiry exploring acceptability of an HIV-oral-self-test (HIVOST) among MSM and TG communities in the district of Pune, India. Discussions were facilitated around an HIVOST kit developed in-country. Most of the participants expressed familiarity with the concept of self-test. They realised that confirmatory diagnostic test would be required following a positive HIVOST screening result. Discrimination from health care workers, crowded environment, lack of privacy and delay in getting reports were hurdles faced during HIV testing at public healthcare facilities. Contrastingly, quick results, painless technique and no-blood-draw were perceived advantages of HIVOST. Innovative suggestions were obtained on how-to-do instruction modalities, kit distribution venues and redressing of apprehensions. Such qualitative responses indicated interest and encouraging level of acceptance around HIVOST among study participants.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…Proper kit design for the target population was often mentioned. Design considerations included the instructional materials [90, 98, 100, 103, 107, 114, 120, 124, 131-133, 187, 190, 201-203] and the type of fluid (blood or oral fluid) [90,92,100,102,104,106,108,110,114,116,119,124,127,131,132,137,139,184,191,196]. Instructions needed to be clear and easy to understand.…”

Section: Positive Perceptions On Hiv-stmentioning

confidence: 99%

“…Selecting the appropriate mode of kit distribution was important to ensure accessibility and adoption [57,78,90,92,99,104,105,108,110,112,119,122,137,139,141,163,184,189,190,202,204]. Modes of distribution described include: (1) direct delivery by community health workers, peers, partners, and sex workers, (2) Home delivery, and (3) Pick up at health facilities or community-based organizations or other sites (e.g., health clubs, markets, private pharmacies, vending machines).…”

Section: Positive Perceptions On Hiv-stmentioning

confidence: 99%

“…Education to modify perceptions on HIV testing in general would then be needed. Education may also address potential problems like improper waste disposal [99,119,132,190,202], safety concerns (e.g., use of lancet as a weapon) [99,137], psychological results of inaccurate tests [93,190], sexual disinhibition due to negative results [100], and misconceptions regarding HIV or HIV-ST [90, 107,110,114,116,122,132] (e.g., How can they trust oral testing if HIV cannot be transmitted via saliva? ).…”

Section: Positive Perceptions On Hiv-stmentioning

confidence: 99%

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Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review

et al. 2021

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Introduction HIV self-testing (HIV-ST) is an effective means of improving HIV testing rates. Low- and middle-income countries (LMIC) are taking steps to include HIV-ST into their national HIV/AIDS programs but very few reviews have focused on implementation in LMIC. We performed a scoping review to describe and synthesize existing literature on implementation outcomes of HIV-ST in LMIC. Methods We conducted a systematic search of Medline, Embase, Global Health, Web of Science, and Scopus, supplemented by searches in HIVST.org and other grey literature databases (done 23 September 2020) and included articles if they reported at least one of the following eight implementation outcomes: acceptability, appropriateness, adoption, feasibility, fidelity, cost, penetration, or sustainability. Both quantitative and qualitative results were extracted and synthesized in a narrative manner. Results and discussion Most (75%) of the 206 included articles focused on implementation in Africa. HIV-ST was found to be acceptable and appropriate, perceived to be convenient and better at maintaining confidentiality than standard testing. The lack of counselling and linkage to care, however, was concerning to stakeholders. Peer and online distribution were found to be effective in improving adoption. The high occurrence of user errors was a common feasibility issue reported by studies, although, diagnostic accuracy remained high. HIV-ST was associated with higher program costs but can still be cost-effective if kit prices remain low and HIV detection improves. Implementation fidelity was not always reported and there were very few studies on, penetration, and sustainability. Conclusions Evidence supports the acceptability, appropriateness, and feasibility of HIV-ST in the LMIC context. Costs and user error rates are threats to successful implementation. Future research should address equity through measuring penetration and potential barriers to sustainability including distribution, cost, scale-up, and safety.

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“…Studies in female sex workers in Uganda [12], Kenya [13], Malawi [14], and Zambia [15] have shown that HIV self-testing can increase the frequency of HIV testing and safer sex practices, decrease stigma associated with HIV testing, provide a user-friendly, rapid, accurate and private setting of testing, as well as an opportunity for decentralized HIV testing and alternative service delivery models. However, there have been few studies examining HIV self-testing among female sex workers in countries outside of sub-Saharan Africa, including China [16][17][18]. Currently, a total of 59 countries globally have policies supporting using HIV self-testing among key populations [19].…”

mentioning

confidence: 99%

Correlates of HIV self-testing among female sex workers in China: implications for expanding HIV screening

Wang

Tucker

et al. 2020

Infect Dis Poverty

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Background Human immunodeficiency virus (HIV) self-testing may help improve test uptake among female sex workers. China has implemented many HIV self-testing programs among men who have sex with men, creating an opportunity for promotion among female sex workers. However, there is a limited literature on examining HIV self-testing among female sex workers. This study aimed to examine HIV self-testing experiences and its determinants among female sex workers in China. Methods A venue-based, cross-sectional study was conducted among Chinese female sex workers in 2019. Participants completed a survey including social-demographic characteristics, sexual behaviors, and HIV self-testing history, the distribution of which were analyzed using descriptive analysis. Multivariable logistic regression was conducted to identify associations with HIV self-testing. Results Among 1287 Chinese female sex workers, 1072 (83.3%, 95% confidence interval [CI] 81.2–85.3%) had ever tested for HIV, and 103 (8.0%, 95% CI 6.6–9.6%) had ever used HIV self-testing. More than half reported that the self-test was their first HIV test (59.2%, 61/103), around one-fifth reported HIV self-testing results influenced the price of sex (21.4%, 22/103). A minority of individuals reported ever experiencing pressure to undertake HIV self-testing (6.8%, 7/103). After adjusting for covariates, HIV self-testing was positively associated with receiving anal sex in the past month (adjusted odds ratio [aOR] = 2.2, 95% CI 1.4–3.5), using drugs before or during sex (aOR = 2.8, 95% CI 1.8–4.5), injecting drugs in the past 6 months (aOR = 2.6, 95% CI 1.2–6.0), being diagnosed with other sexually transmitted infections (aOR = 1.6, 95% CI 1.0–2.5), tested for other sexually transmitted infections in the past six months (aOR = 3.4, 95% CI 2.1–5.5), ever tested in the hospital (aOR = 3.4, 95% CI 2.0–5.6), and ever tested in the community (aOR = 1.5, 95% CI 1.2–1.9). Conclusions Our findings suggest that HIV self-testing could expand overall HIV testing uptake, increase HIV testing frequency, reach sub-groups of high-risk female sex workers and has limited potential harms among female sex workers. HIV self-testing should be incorporated among Chinese female sex workers as a complement to facility-based HIV testing services.

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HIV self-testing in Pune, India: perspectives and recommendations of female sex workers and peer educators

Cited by 9 publications

References 14 publications

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

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

Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review

Correlates of HIV self-testing among female sex workers in China: implications for expanding HIV screening

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