“Bringing testing closer to you” – Barriers and Facilitators in Implementing HIV Self-Testing among Filipino Men-Having-Sex-with-Men and Transgender Women in National Capital Region (NCR), Philippines: A Qualitative Study

Abstract

Objectives: Our study identified barriers and facilitators in implementing HIV Self-Testing (HIVST), including the perceptions of men-having-sex-with-men (MSM) and transgender women on HIVST. Furthermore, we explored the current knowledge, practices, and potential of HIVST among the MSM and TGW populations. Design: Key Informant Interviews (KIIs) were administered using semi-structured interviews administered in both English and Filipin. Thematic analysis of the findings was done after transcribing all audio recordings. Setting: The study was done in the National Capital Region (NCR), Philippines using online video conferencing platforms due to mobility restrictions caused by the COVID-19 pandemic. Participants: All study participants were either MSM or TGW, 18 to 49 years old, and residing/working in NCR. Exclusion criteria include biologically born female and/or currently on pre-exposure prophylaxis (PrEP), antiretroviral therapy (ART) medications, or an HIV-positive diagnosis. Results: Twenty informants were interviewed, of which 75% were MSM, and most of them preferred the use of HIVST. Facilitators and barriers to the use of HIVST were grouped into three main themes: Acceptability, distribution, and monitoring and tracking. Convenience and confidentiality, overcoming fears, and normalization of HIV testing services (HTS) in the country were why the participants preferred HIVST. Social media was recognized as a powerful tool in promoting HIVST. The use of a welcoming tone and positive language should be taken into consideration due to the prevalent HIV stigma. Informants also highlighted that confidentiality must be maintained throughout the whole HIVST process. Conclusions: The identified facilitators and barriers from the study may be considered by the Philippine HTS program implementers. The HIVST strategy may complement the current HTS. It will be very promising to involve the MSM and TGW communities and other key populations to know their HIV status by bringing testing closer to them.