Stakeholders’ perception of a total market approach to HIV self-testing (HIVST) for the private sector in Nigeria

Abstract

Background The continuous supply of affordable and quality HIV self-test (HIVST) is a key pillar toward achieving the global HIV 95–95-95 target in Nigeria. This was a descriptive qualitative study that explored private sector stakeholders’ perceptions of the enablers and barriers of the HIVST market in Nigeria. Methods A total of 29 In-depth interviews (IDIs) were conducted with HIVST supply chain stakeholders and private sector providers (PPMVs and Community Pharmacies). Responses were analyzed using Nvivo software and we systematically developed a total market approach analysis for supply chain stakeholders and archetypes for community Pharmacies and PPMVs based on insights gathered from their journey map. Results Challenges to the supply side dynamics include forecasting, point of care service delivery, the availability of free and subsidized HIVST kits in the market, neglect of private sector providers (Community Pharmacists and PPMVs) in the healthcare delivery system, limited demand for HIVST, and regulatory bottlenecks influences the overall market dynamics. High cost of the HIVST kit, which triggers low availability, accessibility and affordability from the demand side, depicts the need to understand the market dynamics. Addressing the barriers and optimizing the enablers of the three-model pharmacist and PPMV’s will change the market dynamic and service delivery to generate demand. Conclusion To address challenges which already exist, the government need to revise the process guidelines for introducing new HIVST products in the Nigerian market, developing contingency plans to ensure the supply of HIVST remains sufficient when experiencing economic shocks, and create a sustainable roadmap toward optimizing the market for HIVST kits.

Enablers and barriers to effective HIV self-testing in the private sector among sexually active youths in Nigeria: A qualitative study using journey map methodology

“…In this study, we distilled the journey for taking up and using HIVST kits through the attract, purchase, and use stages and later diverges based on their perceived HIVST results. For those who receive a non-reactive result, they proceed to link through the HIV prevention continuum [ 18 – 20 ]. They begin with a link to the HIV prevention services stage followed by retention in such services and later adherence to prevention interventions with repeated testing for HIV acquisition monitoring.…”

Determinants and acceptability of HIV self-testing among vulnerable groups in sub-Saharan Africa: A scoping review protocol

“…30 40 Notwithstanding these limitations, the data collected can be valuable for implementing regular surveillance and developing effective policies for controlling HIV/AIDS. 41 While HIVST holds substantial promise for improving HIV testing rates among at-risk groups in SSA, it is worth noting that the access to HIVST remains limited for these populations. The potential of HIVST can only be fully realised when these barriers to access are adequately addressed and the benefits of such testing are made readily available to these vulnerable groups.…”

“… 30 40 Notwithstanding these limitations, the data collected can be valuable for implementing regular surveillance and developing effective policies for controlling HIV/AIDS. 41 …”