Perspectives on HIV Self-Testing Among Key and Affected Populations in Kenya

BACKGROUND: Kenya's Key and Affected Populations (KAP) – men who have sex with men (MSM), female sex workers, people who inject drugs (PWID), and young women aged 18–24 – often experience stigma and discrimination in Kenyan health care settings due to their identity and/or behaviors, which can deter facility-based testing for HIV. Kenya has promoted self-testing as a means to reach these communities. OBJECTIVES: To identify KAP perspectives on self-testing and place our findings within Kenya's human rights and legal context. METHODS: We conducted 4 focus group discussions (FGD) and 16 in-depth interviews (IDI). One FGD was conducted with each of the following communities: MSM, female sex workers, PWID, and young women aged 18–24. 1–4 IDI were conducted with each KAP community, and 1–3 IDI were conducted with health professionals working on HIV care in each study site. The semi-structured question guideline included one question soliciting opinions on self-testing. RESULTS: KAP support self-testing in concept, however prevailing concerns among participants included access to pre- and post-test counseling services, as well as risk for harms (self-inflicted and otherwise) that might result from a positive result. CONCLUSION: Kenya should ensure that human rights are promoted and respected through implementing rights-based policies and practices for HIV self-testing, including pre- and post-test counseling.