Cargando…
Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities
BACKGROUND: Door-to-door distribution of HIV self-testing kits (HIVST) has the potential to increase uptake of HIV testing services (HTS). However, very few studies have explored the social response to and implications of door-to-door including secondary distribution of HIVST on household relations...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288417/ https://www.ncbi.nlm.nih.gov/pubmed/32527261 http://dx.doi.org/10.1186/s12981-020-00287-y |
_version_ | 1783545271883399168 |
---|---|
author | Bwalya, Chiti Simwinga, Musonda Hensen, Bernadette Gwanu, Lwiindi Hang’andu, Able Mulubwa, Chama Phiri, Mwelwa Hayes, Richard Fidler, Sarah Mwinga, Alwyn Ayles, Helen Bond, Virginia |
author_facet | Bwalya, Chiti Simwinga, Musonda Hensen, Bernadette Gwanu, Lwiindi Hang’andu, Able Mulubwa, Chama Phiri, Mwelwa Hayes, Richard Fidler, Sarah Mwinga, Alwyn Ayles, Helen Bond, Virginia |
author_sort | Bwalya, Chiti |
collection | PubMed |
description | BACKGROUND: Door-to-door distribution of HIV self-testing kits (HIVST) has the potential to increase uptake of HIV testing services (HTS). However, very few studies have explored the social response to and implications of door-to-door including secondary distribution of HIVST on household relations and the ability of individuals to self-test with or without supervision within households. METHODS: A CRT of HIVST distribution was nested within the HPTN 071 (PopART) trial, in four Zambian communities randomised to receive the PopART intervention. The nested HIVST trial aimed to increase knowledge of HIV status at population level. Between February 1 and April 30, 2017, 66 zones (clusters) within these four communities were randomly allocated to either the PopART standard of care door-to-door HTS (33 clusters) or PopART standard of care door-to-door HTS plus oral HIVST (33 clusters). In clusters randomised to HIVST, trained Community HIV care provider (CHiPs) visited households and offered individuals aged ≥ 16 and eligible for an offer of HTS the choice of HIV testing using HIVST or routine door-to-door HTS (finger-prick RDT). To document participants’ experiences with HIVST, Interviews (n = 40), observations (n = 22) and group discussions (n = 91) with household members and CHiPs were conducted. Data were coded using Atlas.ti 7 and analysed thematically. RESULTS: The usage and storage of HIVST kits was facilitated by familiarity with and trust in CHiPs, the novelty of HIVST, and demonstrations and supervision provided by CHiPs. Door-to-door distribution of HIVST kits was appreciated for being novel, convenient, private, empowering, autonomous and easy-to-use. Literacy and age influenced accurate usage of HIVST kits. The novelty of using oral fluids to test for HIV raised questions, some anxiety and doubts about the accuracy of HIVST. Although HIVST protected participants from experiencing clinic-based stigma, it did not address self-stigma. Within households, HIVST usually strengthened relationships but, amongst couples, there were a few reports of social harms. CONCLUSION: Door-to-door distribution of HIVST as a choice for how to HIV test is appreciated at community level and provides an important testing option in the sub-Saharan context. However, it should be accompanied by counselling to manage social harms and by supporting those testing HIV-positive to link to care. |
format | Online Article Text |
id | pubmed-7288417 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72884172020-06-11 Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities Bwalya, Chiti Simwinga, Musonda Hensen, Bernadette Gwanu, Lwiindi Hang’andu, Able Mulubwa, Chama Phiri, Mwelwa Hayes, Richard Fidler, Sarah Mwinga, Alwyn Ayles, Helen Bond, Virginia AIDS Res Ther Research BACKGROUND: Door-to-door distribution of HIV self-testing kits (HIVST) has the potential to increase uptake of HIV testing services (HTS). However, very few studies have explored the social response to and implications of door-to-door including secondary distribution of HIVST on household relations and the ability of individuals to self-test with or without supervision within households. METHODS: A CRT of HIVST distribution was nested within the HPTN 071 (PopART) trial, in four Zambian communities randomised to receive the PopART intervention. The nested HIVST trial aimed to increase knowledge of HIV status at population level. Between February 1 and April 30, 2017, 66 zones (clusters) within these four communities were randomly allocated to either the PopART standard of care door-to-door HTS (33 clusters) or PopART standard of care door-to-door HTS plus oral HIVST (33 clusters). In clusters randomised to HIVST, trained Community HIV care provider (CHiPs) visited households and offered individuals aged ≥ 16 and eligible for an offer of HTS the choice of HIV testing using HIVST or routine door-to-door HTS (finger-prick RDT). To document participants’ experiences with HIVST, Interviews (n = 40), observations (n = 22) and group discussions (n = 91) with household members and CHiPs were conducted. Data were coded using Atlas.ti 7 and analysed thematically. RESULTS: The usage and storage of HIVST kits was facilitated by familiarity with and trust in CHiPs, the novelty of HIVST, and demonstrations and supervision provided by CHiPs. Door-to-door distribution of HIVST kits was appreciated for being novel, convenient, private, empowering, autonomous and easy-to-use. Literacy and age influenced accurate usage of HIVST kits. The novelty of using oral fluids to test for HIV raised questions, some anxiety and doubts about the accuracy of HIVST. Although HIVST protected participants from experiencing clinic-based stigma, it did not address self-stigma. Within households, HIVST usually strengthened relationships but, amongst couples, there were a few reports of social harms. CONCLUSION: Door-to-door distribution of HIVST as a choice for how to HIV test is appreciated at community level and provides an important testing option in the sub-Saharan context. However, it should be accompanied by counselling to manage social harms and by supporting those testing HIV-positive to link to care. BioMed Central 2020-06-11 /pmc/articles/PMC7288417/ /pubmed/32527261 http://dx.doi.org/10.1186/s12981-020-00287-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Bwalya, Chiti Simwinga, Musonda Hensen, Bernadette Gwanu, Lwiindi Hang’andu, Able Mulubwa, Chama Phiri, Mwelwa Hayes, Richard Fidler, Sarah Mwinga, Alwyn Ayles, Helen Bond, Virginia Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities |
title | Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities |
title_full | Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities |
title_fullStr | Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities |
title_full_unstemmed | Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities |
title_short | Social response to the delivery of HIV self-testing in households: experiences from four Zambian HPTN 071 (PopART) urban communities |
title_sort | social response to the delivery of hiv self-testing in households: experiences from four zambian hptn 071 (popart) urban communities |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288417/ https://www.ncbi.nlm.nih.gov/pubmed/32527261 http://dx.doi.org/10.1186/s12981-020-00287-y |
work_keys_str_mv | AT bwalyachiti socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT simwingamusonda socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT hensenbernadette socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT gwanulwiindi socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT hanganduable socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT mulubwachama socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT phirimwelwa socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT hayesrichard socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT fidlersarah socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT mwingaalwyn socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT ayleshelen socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT bondvirginia socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities AT socialresponsetothedeliveryofhivselftestinginhouseholdsexperiencesfromfourzambianhptn071poparturbancommunities |