HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HIV testing services in Ethiopia

Abstract

IntroductionHIV is still an enormous global burden and it is also causing loss of huge health care workers (HCWs) on the already limited human resource capacity in health care services in Sub-Saharan Africa. Variety of methods of accelerating HIV testing is required to increase the rate of HIV testing and expand treatment services. Therefore, this study was aimed to find out the prevalence, feasibility and options of HIV self-testing practices in Ethiopia.MethodsA cross-sectional study design triangulated with qualitative method was conducted from February to May, 2012. The data was collected using a semi-structured pretested questionnaire and in-depth interview, at government and private health centers or clinics and hospitals. During the data collection all the available healthcare workers (HCWs) which encompass the internship students including: Medical, Health Officer, Nurses, Midwives and Laboratory students, and health professionals working in the selected health institutions were involved.ResultsA total of 307 HCWs were included in the analysis and we found that 288(94.4%) of them were ever tested for HIV, of which majority 203 (70.5%) were tested by themselves though 244(80%) of the HCWs had motivation or interest to be tested by themselves. Generally, of the ever tested only 85(29.5%) were tested by the help of health care providers/counselors other than self. Regarding the place where the HCWs had the test, majority 136 (69.4%) tested by themselves at the health facility and the rest were tested at their home, office, market and church. The main reason stated for self-testing was the need for confidentiality for the test result, which was mentioned by 205(82%). Moreover, 35(14.0%) claims lack of time to access the ordinary counseling and testing services.ConclusionThis study depicts high rate of HIV self-testing practice among HCWs. This shows that HIV self-testing can be considered as one pillar to increase the HIV-testing services and a means for the HIV prevention and control policy, through increasing HIV testing uptake and awareness of HIV status. However, the implementation may require the role of different stakeholders and decision makers with further study to extend the options.

Factors Associated with Acceptability of HIV Self-Testing Among Health Care Workers in Kenya

“…However, these studies do provide general insights on HIV testing tendencies among HCWs. In a study of HIVST among HCWs in Ethiopia, it was reported that a higher proportion of nurses than doctors self-tested for HIV, but there was no difference by gender in the proportion of HCWs who reported self-testing [9]. Thus, there is limited information on factors associated with uptake of HIVST among HCWs, and our study has provided some insight on the characteristics of HCWs who find HIVST acceptable.…”

“…In Ethiopia, a study among HCWs showed that 70 % of those who had ever had an HIV test had also self-tested [9], the main reason being the need for privacy. Thus, a well-implemented HIVST program could be an effective way for increasing uptake of HIV testing with increased privacy, and increasing entry into HIV prevention, care and treatment services, such as early ARVs and access to PEP.…”

Men’s perspectives on HIV self-testing in sub-Saharan Africa: a systematic review and meta-synthesis

“…While several studies have documented the high acceptance of HIVST among populations [16,[38][39][40] and its convenience [41,42], this, to our knowledge, is the first systematic review and meta-synthesis to assess men's perspectives on HIVST in SSA. While education is key to changing men's perspectives and improving HIV knowledge, this study further revealed that HIV self-testing is critical to addressing issues of confidentiality and convenience [9,16,43,44].…”

Who to test and how to test for chronic hepatitis C infection – 2016 WHO testing guidance for low- and middle-income countries

“…The self-testing approach offers distinct advantages. By giving people the opportunity to test discreetly and conveniently, self-testing may increase the uptake of testing among people not reached by other existing testing services many whom are first-time testers [204][205][206][207]. The experience with hepatitis self-testing is currently very limited, but it represents a potentially important approach to expand access to hepatitis testing in the future.…”