Cargando…

Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana

BACKGROUND: HIV prevalence among female sex workers (FSW) in sub-Saharan Africa is much higher than in the general population. HIV self-testing (HIVST) may be useful for increasing testing rates in FSW. METHODS: We conducted semi-structured in-depth interviews among FSW, nurses and lay counsellors p...

Descripción completa

Detalles Bibliográficos
Autores principales: Shava, Emily, Manyake, Kutlo, Mdluli, Charlotte, Maribe, Kamogelo, Monnapula, Neo, Nkomo, Bornapate, Mosepele, Mosepele, Moyo, Sikhulile, Mmalane, Mompati, Bärnighausen, Till, Makhema, Joseph, Bogart, Laura M., Lockman, Shahin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384658/
https://www.ncbi.nlm.nih.gov/pubmed/32716966
http://dx.doi.org/10.1371/journal.pone.0236052
_version_ 1783563643350155264
author Shava, Emily
Manyake, Kutlo
Mdluli, Charlotte
Maribe, Kamogelo
Monnapula, Neo
Nkomo, Bornapate
Mosepele, Mosepele
Moyo, Sikhulile
Mmalane, Mompati
Bärnighausen, Till
Makhema, Joseph
Bogart, Laura M.
Lockman, Shahin
author_facet Shava, Emily
Manyake, Kutlo
Mdluli, Charlotte
Maribe, Kamogelo
Monnapula, Neo
Nkomo, Bornapate
Mosepele, Mosepele
Moyo, Sikhulile
Mmalane, Mompati
Bärnighausen, Till
Makhema, Joseph
Bogart, Laura M.
Lockman, Shahin
author_sort Shava, Emily
collection PubMed
description BACKGROUND: HIV prevalence among female sex workers (FSW) in sub-Saharan Africa is much higher than in the general population. HIV self-testing (HIVST) may be useful for increasing testing rates in FSW. METHODS: We conducted semi-structured in-depth interviews among FSW, nurses and lay counsellors providing services to FSWs in Botswana. We aimed to gain understanding of perceived acceptability, anticipated barriers, and preferred approaches to HIVST among FSW. Interviews were audio-recorded, transcribed and translated. Transcripts were reviewed and coded independently by two investigators; high inter-coder agreement was achieved (Kappa = 0.80). RESULTS: We interviewed five care providers whose average age was 40 years (SD = 2,64, range = 37–43); three nurses and two counsellors. Thirty FSW were interviewed, with mean age 34 years (range = 20–52). Most (27; 90%) FSW expressed great interest in using HIVST kits. Facilitators of HIVST were: awareness of own risky sexual behaviours, desire to stay healthy, and perceived autonomy over one’s healthcare decisions. Perceived advantages of HIVST included convenience, privacy, and perception of decreased stigma. Identified barriers to HIVST included lack of knowledge about the HIVST kit, fear of testing due to anticipated stigma, mistrust of the test’s accuracy, doubt of self-competency to perform HIVST, and concerns about not linking to care. Assisting someone to test was noted as good for providing emotional support, but there were concerns about confidentiality breaches. Providers expressed concerns over low literacy among FSWs which could affect comprehension of testing instructions, and competency to perform testing and interpret results. Participants’ recommendations for implementation of HIVST included: ensuring wide dissemination of information on HIVST, engaging peers in information-sharing and education, making test kits accessible in FSW-friendly centres, and having clear instructions for linkage to healthcare and support. CONCLUSION: HIVST shows high acceptability among FSWs in Gaborone Botswana, with providers expressing some concerns. Implementation should be peer-driven with healthcare provider oversight.
format Online
Article
Text
id pubmed-7384658
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-73846582020-08-05 Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana Shava, Emily Manyake, Kutlo Mdluli, Charlotte Maribe, Kamogelo Monnapula, Neo Nkomo, Bornapate Mosepele, Mosepele Moyo, Sikhulile Mmalane, Mompati Bärnighausen, Till Makhema, Joseph Bogart, Laura M. Lockman, Shahin PLoS One Research Article BACKGROUND: HIV prevalence among female sex workers (FSW) in sub-Saharan Africa is much higher than in the general population. HIV self-testing (HIVST) may be useful for increasing testing rates in FSW. METHODS: We conducted semi-structured in-depth interviews among FSW, nurses and lay counsellors providing services to FSWs in Botswana. We aimed to gain understanding of perceived acceptability, anticipated barriers, and preferred approaches to HIVST among FSW. Interviews were audio-recorded, transcribed and translated. Transcripts were reviewed and coded independently by two investigators; high inter-coder agreement was achieved (Kappa = 0.80). RESULTS: We interviewed five care providers whose average age was 40 years (SD = 2,64, range = 37–43); three nurses and two counsellors. Thirty FSW were interviewed, with mean age 34 years (range = 20–52). Most (27; 90%) FSW expressed great interest in using HIVST kits. Facilitators of HIVST were: awareness of own risky sexual behaviours, desire to stay healthy, and perceived autonomy over one’s healthcare decisions. Perceived advantages of HIVST included convenience, privacy, and perception of decreased stigma. Identified barriers to HIVST included lack of knowledge about the HIVST kit, fear of testing due to anticipated stigma, mistrust of the test’s accuracy, doubt of self-competency to perform HIVST, and concerns about not linking to care. Assisting someone to test was noted as good for providing emotional support, but there were concerns about confidentiality breaches. Providers expressed concerns over low literacy among FSWs which could affect comprehension of testing instructions, and competency to perform testing and interpret results. Participants’ recommendations for implementation of HIVST included: ensuring wide dissemination of information on HIVST, engaging peers in information-sharing and education, making test kits accessible in FSW-friendly centres, and having clear instructions for linkage to healthcare and support. CONCLUSION: HIVST shows high acceptability among FSWs in Gaborone Botswana, with providers expressing some concerns. Implementation should be peer-driven with healthcare provider oversight. Public Library of Science 2020-07-27 /pmc/articles/PMC7384658/ /pubmed/32716966 http://dx.doi.org/10.1371/journal.pone.0236052 Text en © 2020 Shava et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Shava, Emily
Manyake, Kutlo
Mdluli, Charlotte
Maribe, Kamogelo
Monnapula, Neo
Nkomo, Bornapate
Mosepele, Mosepele
Moyo, Sikhulile
Mmalane, Mompati
Bärnighausen, Till
Makhema, Joseph
Bogart, Laura M.
Lockman, Shahin
Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana
title Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana
title_full Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana
title_fullStr Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana
title_full_unstemmed Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana
title_short Acceptability of oral HIV self-testing among female sex workers in Gaborone, Botswana
title_sort acceptability of oral hiv self-testing among female sex workers in gaborone, botswana
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384658/
https://www.ncbi.nlm.nih.gov/pubmed/32716966
http://dx.doi.org/10.1371/journal.pone.0236052
work_keys_str_mv AT shavaemily acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT manyakekutlo acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT mdlulicharlotte acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT maribekamogelo acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT monnapulaneo acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT nkomobornapate acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT mosepelemosepele acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT moyosikhulile acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT mmalanemompati acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT barnighausentill acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT makhemajoseph acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT bogartlauram acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana
AT lockmanshahin acceptabilityoforalhivselftestingamongfemalesexworkersingaboronebotswana