Acceptability, willingness to use and preferred distribution models of oral-based HIV self-testing kits among key and priority populations enrolled in HIV pre-exposure prophylaxis clinics in central Uganda. A mixed-methods cross-sectional study

Abstract

AbstractKey Populations (KPs) and Priority Populations (PPs) taking Pre-Exposure Prophylaxis (PrEP) for HIV prevention require routine HIV testing every after three months. HIV self-testing could be an alternative testing approach for these population categories. We assessed the acceptability of oral-based HIV Self-Testing (HIVST) among Key and priority Populations taking PrEP in central Uganda. A mixed methods cross-sectional study was conducted on 367 key and priority populations attending Pre-Exposure Prophylaxis clinics in central Uganda, from May to August 2018. KPs and PPs were introduced to the Oraquick HIV self-testing kit as an option for HIV testing during their routine visit to the PrEP clinic. A demonstration of how to perform HIV self-testing was conducted using an Oraquick demonstration video and leaflet inserts after which, respondents were asked to choose between HIVST and the conventional facility blood-based HIV testing. Those willing to use the oral kit were asked to voluntarily consent, were provided with an Oraquick HIVST kit and were assisted to perform the test. Quantitative data were presented as proportions for each outcome variable. Thematic analysis was performed to explore factors that promote and inhibit HIVST. HIV self-testing acceptability; defined as the proportion of those who performed an HIVST test among those approached was 99.5% (365/367). Using an oral fluid-based kit “Oraquick” was reported to be free of pain, convenient, easy to use and time saving hence preferred over other HIV testing modalities. A multimodal approach to distributing HIV self-testing kits was suggested by respondents. Oral-based HIV self-testing is highly acceptable among key and priority populations taking Pre-Exposure Prophylaxis and can be adopted as an alternative to the conventional routine three monthly facility-based provider dependent HIV screening. Kits’ distribution may employ several models. Majority of key populations would afford the kits at a cost of not more than 1.4USD if not provided free of charge.