"I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe

Indravudh, Pitchaya P, Sibanda, Euphemia ORCID: https://orcid.org/0000-0003-1754-1076, d'Elbee, Marc, Kumwenda, Moses K, Ringwald, Beate, Maringwa, Galven, Simwinga, Musonda, Nyirenda, Lot, Hatzold, Karin, Johnson, Cheryl C, Terris-Prestholt, Fern and Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536 (2017) '"I will choose when to test, where I want to test": Investigating young people's preferences for HIV self-testing in Malawi and Zimbabwe'. AIDS, Vol 31, Issue S3, S203-S212.

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Abstract

Objectives
This study identifies young people’s preferences for HIV self-testing (HIVST) delivery, determines the relative strength of preferences and explores underlying behaviors and perceptions to inform youth-friendly services in southern Africa.

Design
A mixed methods design was adopted in Malawi and Zimbabwe and includes focus group discussions (FGD), in-depth interviews (IDI) and discrete choice experiments (DCE).

Methods
This study was conducted during the formative phase of cluster randomized trials of oral-fluid HIVST distribution. Young people aged 16-25 years were purposively selected for IDIs (n=15) in Malawi and 12 FGDs (n=107) across countries. A representative sample of young people were administered a DCE on HIVST delivery, with data analyzed to estimate relative preferences for service characteristics. The qualitative results provided additional depth and were triangulated with the quantitative findings

Results
There was strong concordance across methods and countries based on the three triangulation parameters: product, provider and service characteristics. HIVST was highly accepted by young people, if provided at no or very low cost. Young people expressed mixed views on oral-fluid tests, weighing perceived benefits with accuracy concerns. There was an expressed lack of trust in health providers and preference for lay community distributors. HIVST addressed youth-specific barriers to standard HIV testing, with home-based distribution considered convenient. Issues of autonomy, control, respect, and confidentiality emerged as key qualitative themes.

Conclusion
HIVST services can be optimized to reach young people if products are provided through home-based distribution and at low costs, with respect for them as autonomous individuals.

Item Type:	Article
Subjects:	WA Public Health > WA 20.5 Research (General) WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.1 Diagnosis WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1097/QAD.0000000000001516
Depositing User:	Stacy Murtagh
Date Deposited:	04 Jul 2017 16:07
Last Modified:	17 Oct 2019 10:52
URI:	https://archive.lstmed.ac.uk/id/eprint/7056

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