Enthusiasm for Introducing and Integrating HIV Self-Testing but Doubts About Users: A Baseline Qualitative Analysis of Key Stakeholders' Attitudes and Perceptions in Côte d'Ivoire, Mali and Senegal

Frontiers in Public Health

Souleymane Sow¹  Dolorès Pourette²  Nicolas Rouveau²  Joseph Larmarange²  Sokhna Boye²  Mathieu Maheu-Giroux³  Sidi Cheick Camara⁴  Alexis Brou Kouadio⁵  Anthony Vautier⁶  Younoussa Sidibé⁷  Alice Desclaux⁸  Odette Ky-Zerbo⁹ 

[1] Center Régional de Recherche et de Formation à la Prise en Charge Clinique de Fann (CRCF), Dakar, Senegal;Ceped, IRD, Université de Paris, Inserm, Paris, France;Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada;Département Santé, Institut Malien de Recherche en Sciences Sociales (IMRSS), Bamako, Mali;Département de Sociologie, Institut d'ethnosociologie (IES), Université Félix Houphouët Boigny de Cocody, Abidjan, Côte d'Ivoire;Solidarité Thérapeutique et Initiatives Pour la Santé, Dakar, Senegal;Solidarité Thérapeutique et Initiatives pour la Santé, Bamako, Mali;TransVIHMI, IRD, INSERM, University of Montpellier, Center Régional de Recherche et de Formation au VIH et Maladies Associées de Fann, Dakar, Senegal;TransVIHMI, Université de Montpellier, IRD, INSERM, Montpellier, France;

关键词: HIV self-testing;    key population;    perceptions;    stakeholders;    West Africa;    ATLAS;   

DOI  :  10.3389/fpubh.2021.653481

来源: Frontiers

【 摘 要 】

Since 2019, the ATLAS project, coordinated by Solthis in collaboration with national AIDS programs, has introduced, promoted and delivered HIV self-testing (HIVST) in Côte d'Ivoire, Mali and Senegal. Several delivery channels have been defined, including key populations: men who have sex with men, female sex workers and people who use injectable drugs. At project initiation, a qualitative study analyzing the perceptions and attitudes of key stakeholders regarding the introduction of HIVST in their countries and its integration with other testing strategies for key populations was conducted. The study was conducted from September to November 2019 within 3 months of the initiation of HIVST distribution. Individual interviews were conducted with 60 key informants involved in the project or in providing support and care to key populations: members of health ministries, national AIDS councils, international organizations, national and international non-governmental organizations, and peer educators. Semi structured interviews were recorded, translated when necessary, and transcribed. Data were coded using Dedoose© software for thematic analyses. We found that stakeholders' perceptions and attitudes are favorable to the introduction and integration of HIVST for several reasons. Some of these reasons are held in common, and some are specific to each key population and country. Overall, HIVST is considered able to reduce stigma; preserve anonymity and confidentiality; reach key populations that do not access testing via the usual strategies; remove spatial barriers; save time for users and providers; and empower users with autonomy and responsibility. It is non-invasive and easy to use. However, participants also fear, question and doubt users' autonomy regarding their ability to use HIVST kits correctly; to ensure quality secondary distribution; to accept a reactive test result; and to use confirmation testing and care services. For stakeholders, HIVST is considered an attractive strategy to improve access to HIV testing for key populations. Their doubts about users' capacities could be a matter for reflective communication with stakeholders and local adaptation before the implementation of HIVST in new countries. Those perceptions may reflect the West African HIV situation through the emphasis they place on the roles of HIV stigma and disclosure in HIVST efficiency.

【 授权许可】

CC BY