Exploring factors that influence the integration of HIVST with HCT using a qualitative comparative cross-over design in KwaZulu-Natal, South Africa

The World Health Organization recommends using HIV self-testing (HIVST) to improve HIV testing coverage by integrating self-testing for HIV into public domain primary healthcare (PHC) clinics in areas with a high burden of HIV. However, an understanding of the relationship and interaction between HI...

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Bibliographic Details
Published in:Global public health 2019-09, Vol.14 (9), p.1275-1287
Main Authors: Harichund, Charlene, Karim, Quarraisha Abdool, Kunene, Pinky, Simelane, Sinenhlanhla, Moshabela, Mosa
Format: Article
Language:English
Subjects:
Adult
Clinics
Counseling
Cross-Over Studies
Crossovers
Female
HCT
HIV
HIV Infections - diagnosis
HIV Infections - epidemiology
HIV status awareness
Human immunodeficiency virus
Humans
Incidence
Interviews as Topic
Male
Medical tests
Patient Acceptance of Health Care
Patient Preference
Prevalence
Primary care
Public domain
Public health
Qualitative Research
Self Care
Self testing
South Africa
South Africa - epidemiology
Tests
Volunteers
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Summary:The World Health Organization recommends using HIV self-testing (HIVST) to improve HIV testing coverage by integrating self-testing for HIV into public domain primary healthcare (PHC) clinics in areas with a high burden of HIV. However, an understanding of the relationship and interaction between HIVST and the standard HIV counselling and testing (HCT), the primary HIV testing approach within public PHC clinics, is limited. We therefore sought to compare experiences of people seeking an HIV test, specifically, how HIVST can be used to enhance HCT when introduced together. A cross-over study design was used wherein participants were randomly exposed to either HCT followed by HIVST or HIVST followed by HCT. Semi-structured interviews were conducted at the baseline, and after each testing exposure. Forty volunteers were enrolled and 119 interviews were completed. Although a higher preference for HIVST was reported, a symbiotic relationship between HIVST and HCT was identified, where benefits of one testing approach overcame barriers of the other. Introducing HIVST as an additional testing approach with HCT within PHC facilities in South Africa could positively influence HIV testing given their complementary relationship. HIVST and HCT should accommodate HIV testing situations among HIV testing naïve and repeat testing populations.
ISSN:1744-1692
1744-1706
DOI:10.1080/17441692.2019.1587638