Kelvin, E.A., Cheruvillil, S., Christian, S., et al., African Journal of AIDS Research (2016), 15(2): 99–108, doi: 10.2989/16085906.2016.1189442.
Increasing HIV testing rates is essential to the scale-up of combination prevention packages, including treatment as prevention and pre-exposure prophylaxis. Alternative HIV testing models may increase uptake among populations who are hesitant to access clinic-based testing. This qualitative study explored perceptions of home-based HIV self-testing through 20 semi-structured interviews with primary health care patients in South Africa in 2010. Nine interviewees viewed home testing favorably; eight viewed it unfavorably; and three had no preference. Despite mixed opinions, the majority of participants (n=16) thought that uptake of self-testing in South Africa would be common; and 14 said that they would use a home test. Positive perceptions of home testing included privacy, time savings, increased potential for repeat self-testing, and convenience. Half the participants mentioned negative consequences such as emotional trauma, including self-inflicted harm when positive results occur. Individuals who had previously been tested, were in a committed relationship, and considered themselves unlikely to be HIV-positive were more likely to view home testing positively. Men were also more open to self-administered testing than women. Couples home testing was more likely within a committed relationship, rather than in a casual relationship, where condom use was more likely. Providing a variety of testing options may permit people to select the testing method that best suits their specific needs.