Venues and methods to improve professional men’s access to HIV self-testing and linkage to HIV prevention or treatment: a qualitative study

Abstract

Background HIV testing among men in sub-Saharan Africa is sub-optimal. Despite several strategies to improve access to underserved populations, evidence regarding engaging men in professional and formal occupations in HIV testing is limited. This study explored employed professional men’s preferences for uptake of HIV self-testing, and linkage to HIV care, or prevention services. Methods This was an explorative-descriptive qualitative study where a sample of 33 men from six Ugandan urban centres. Participants were purposively selected guided by the International Standard Classification of Occupations to participate in in-depth interviews. The data were collected using an interview guide and the sample size was determined by data saturation. Eligibility criteria included fulltime formal employment for over a year at that organization. The data were analyzed manually using thematic content analysis. Results Three categories emerged: uptake of HIV self-tests, process of HIV self-testing and linkage to post-test services. The different modes of distribution of HIV self-test kits included secondary distribution, self-tests at typically male dominated spaces, delivery to workplaces and technology-based delivery. The process of HIV self-testing may be optimized by providing collection bins, and mHealth or mobile phone applications. Linkage to further care or prevention services may be enhanced using medical insurance providers, giving incentives and tele counselling. Conclusion We recommend utilization of several channels for the uptake of HIV self-tests. These include distribution of test kits both to offices and men’s leisure and recreation ‘hot spots’, Additionally, female partners, peers and established men’s group including social media groups can play a role in improving the uptake of HIV self-testing. Mobile phones and digital technology can be applied in innovative ways for the return of test results and to strengthen linkage to care or prevention services. Partnership with medical insurers may be critical in engaging men in professional employment in HIV services.

Linkage to HIV Care Following HIV Self-testing Among Men: Systematic Review of Quantitative and Qualitative Studies from Six Countries in Sub-Saharan Africa

“…But if you put a test and said those who take the test and go for treatment will be given something, then I would be willing to participate. ([ 50 ], p. 8). You could even motivate them that you will give them a reward when they bring back the results or when they go for other services.…”

“…But if you put a test and said those who take the test and go for treatment will be given something, then I would be willing to participate. ([ 50 ], p. 8).…”

“…Evidence about the most appropriate strategies for increasing follow up after HIVST was reported in eight studies [ 43 – 46 , 49 , 50 , 52 , 54 ]. These consisted of five qualitative studies, two quantitative studies, and one mixed methods study.…”

“…In this era of COVID and with our busy schedules it’s very hard for me to keep going to the facility, but if I have somebody to continually offer guidance and information, I think it makes it easier. ([ 50 ], p. 8).…”

Linkage to HIV care following HIV self-testing among men: systematic review of quantitative and qualitative studies from six countries in sub-Saharan Africa

“…The included studies were conducted in the following countries: Zambia (43), Malawi (26,44,45), Tanzania (46), Uganda (47)(48)(49)(50), South Africa (51-54), and Kenya (55, 56). There were seven quantitative studies, seven qualitative studies, and one mixed methods study.…”