"I Think It Is Right": A Qualitative Exploration of the Acceptability and Desired Future Use of Oral Swab and Finger-Prick HIV Self-Tests by Lay Users in KwaZulu-Natal, South Africa

November 2017 - Combination Prevention

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Knight, L., Makusha, T., Lim, J., et al. BMC Research Notes (2017), 10: 486, doi: 10.1186/s13104-017-2810-7.

This qualitative study examined the acceptability and usability of HIV self-testing (HIVST) prototypes (including oral swab and finger-prick) among 50 lay-users in South Africa. Eighty percent found the tests easy to use, regardless of prototype. Respondents praised the convenience and confidentiality of HIVST and liked that they could test alone. A few respondents mentioned a need for counseling, information, and follow-up, suggesting several solutions, including printed counseling inside the test package, SMS messaging, and a telephone number to call. Suggestions for future HIVST use included improved instructions for finger-prick tests, though some respondents expressed concerns about the pain associated with the finger-prick. Participants felt that HIVST should be offered free of charge, or made available to buy at health facilities, pharmacies, or supermarkets. Ninety-eight percent stated that they would use the HIVST again if it was free, and 86 percent would purchase an HIVST. The 14 percent who were neutral or would not buy a test used the finger-prick test. Respondents said that HIVST would likely encourage greater testing coverage. The authors concluded that HIVST is acceptable among lay users, and that the oral swab was found the most acceptable. Policymakers should further consider these findings when considering the rollout of HIVST.

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