Choko, A.T., Kumwenda, M.K., Johnson, C.C., et al. Journal of the International AIDS Society (June 2017), 20:2161, doi:1 0.7448/IAS.20.1.21610.
This qualitative study, conducted in anticipation of a randomized controlled trial (RCT) in Malawi, examined perceptions of female-delivered HIV self-testing (HST) kits delivered to male partners during antenatal care. The authors examined perceptions via focus group discussions and in-depth interviews. These discussions identified barriers to HST, including stigma, cost and time requirements, and fear of blame from partner following a positive diagnosis. Both men and women were willing to accept HST kits delivered by pregnant women; they also noted that HST offered privacy for men and addressed the stigma associated with visiting a clinic. Concerns included lack of immediate post-test counseling and the potential for abuse if the partner feels that he was not consulted or that the woman does not trust him. Participants said that the manner in which a woman raised the subject of HST to her partner was critical, and suggested using bedtime or a letter from the clinic to support the discussion. Strategies for increasing HST and linkages included financial incentives, transport costs, lottery, and either text or telephone reminders, although participants preferred the latter, given the increased ability to dialogue. The researchers adapted the upcoming RCT’s methodology to include USD$10 cash or lottery participation as incentives, and telephone call reminders instead of texting.