Mugo P.M., Micheni M., Shangala J., et al. PLOS ONE (January 2017), 12(1): e0170868, doi:10.1371/journal.pone.0170868.
This study assessed the feasibility of pharmacy-based HIV self-testing (HST) in an urbanizing area of coastal Kenya. Between 2015–2016, staff and research assistants at five pharmacies recruited adult clients (≥18 years) seeking services that might suggest HIV risk, including HIV testing, treatment for sexually transmitted infections, malaria/fever treatment, pregnancy testing, and needles/syringes. Participants were offered oral HST kits at USD$1 per test. A total of 463 clients were invited to participate; 174 clients (38%) enrolled and 161 purchased a test. Only 4 percent of non-testers cited inability to pay as the reason for not participating. Uptake of HST was high among clients seeking HIV testing (84%), but low among those seeking other services (11%). Within one week, participants were contacted for post-test data collection and counseling. All but one tester found the process easy (29%) or very easy (70%). Participants cited privacy, followed by personal empowerment, as the main advantages of HST; and risk of distress/harm when testing without a counselor present as the main disadvantage. A majority agreed or strongly agreed (35% and 59%, respectively) that HST kits should be widely available. Demand for HST kits persisted after the study and participating providers expressed interest in continuing to offer HST. The authors noted concerns about the low uptake among clients seeking services other than HIV.