Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study

Abstract Background Facility HIV self-testing (HIVST) within outpatient departments can increase HIV testing coverage by facilitating HIVST use in outpatient waiting spaces while clients wait for routine care. Facility HIVST allows for the majority of outpatients to test with minimal health care wor...

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Autores principales:	Misheck Mphande, Paula Campbell, Risa M. Hoffman, Khumbo Phiri, Mike Nyirenda, Sundeep K. Gupta, Vincent Wong, Kathryn Dovel
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/18e55f5f9e074fc8af55951874ba7832
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spelling	oai:doaj.org-article:18e55f5f9e074fc8af55951874ba78322021-12-05T12:09:44ZBarriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study10.1186/s12889-021-12213-61471-2458https://doaj.org/article/18e55f5f9e074fc8af55951874ba78322021-12-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12213-6https://doaj.org/toc/1471-2458Abstract Background Facility HIV self-testing (HIVST) within outpatient departments can increase HIV testing coverage by facilitating HIVST use in outpatient waiting spaces while clients wait for routine care. Facility HIVST allows for the majority of outpatients to test with minimal health care worker time requirements. However, barriers and facilitators to outpatients’ use of facility HIVST are still unknown. Methods As part of a cluster randomized trial on facility HIVST in Malawi, we conducted in-depth interviews with 57 adult outpatients (> 15 years) who were exposed to the HIVST intervention and collected observational journals that documented study staff observations from facility waiting spaces where HIVST was implemented. Translated and transcribed data were analyzed using constant comparison analysis in Atlas.ti. Results Facility HIVST was convenient, fast, and provided autonomy to outpatients. The strategy also had novel facilitators for testing, such as increased motivation to test due to seeing others test, immediate support for HIVST use, and easy access to additional HIV services in the health facility. Barriers to facility HIVST included fear of judgment from others and unwanted status disclosure due to lack of privacy. Desired changes to the intervention included private, separate spaces for kit use and interpretation and increased opportunity for disclosure and post-test counseling. Conclusions Facility HIVST was largely acceptable to outpatients in Malawi with novel facilitators that are unique to facility HIVST in OPD waiting spaces. Trial registration The parent trial is registered with ClinicalTrials.gov , NCT03271307 , and Pan African Clinical Trials, PACTR201711002697316.Misheck MphandePaula CampbellRisa M. HoffmanKhumbo PhiriMike NyirendaSundeep K. GuptaVincent WongKathryn DovelBMCarticlePublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Public aspects of medicine RA1-1270
spellingShingle	Public aspects of medicine RA1-1270 Misheck Mphande Paula Campbell Risa M. Hoffman Khumbo Phiri Mike Nyirenda Sundeep K. Gupta Vincent Wong Kathryn Dovel Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study
description	Abstract Background Facility HIV self-testing (HIVST) within outpatient departments can increase HIV testing coverage by facilitating HIVST use in outpatient waiting spaces while clients wait for routine care. Facility HIVST allows for the majority of outpatients to test with minimal health care worker time requirements. However, barriers and facilitators to outpatients’ use of facility HIVST are still unknown. Methods As part of a cluster randomized trial on facility HIVST in Malawi, we conducted in-depth interviews with 57 adult outpatients (> 15 years) who were exposed to the HIVST intervention and collected observational journals that documented study staff observations from facility waiting spaces where HIVST was implemented. Translated and transcribed data were analyzed using constant comparison analysis in Atlas.ti. Results Facility HIVST was convenient, fast, and provided autonomy to outpatients. The strategy also had novel facilitators for testing, such as increased motivation to test due to seeing others test, immediate support for HIVST use, and easy access to additional HIV services in the health facility. Barriers to facility HIVST included fear of judgment from others and unwanted status disclosure due to lack of privacy. Desired changes to the intervention included private, separate spaces for kit use and interpretation and increased opportunity for disclosure and post-test counseling. Conclusions Facility HIVST was largely acceptable to outpatients in Malawi with novel facilitators that are unique to facility HIVST in OPD waiting spaces. Trial registration The parent trial is registered with ClinicalTrials.gov , NCT03271307 , and Pan African Clinical Trials, PACTR201711002697316.
format	article
author	Misheck Mphande Paula Campbell Risa M. Hoffman Khumbo Phiri Mike Nyirenda Sundeep K. Gupta Vincent Wong Kathryn Dovel
author_facet	Misheck Mphande Paula Campbell Risa M. Hoffman Khumbo Phiri Mike Nyirenda Sundeep K. Gupta Vincent Wong Kathryn Dovel
author_sort	Misheck Mphande
title	Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study
title_short	Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study
title_full	Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study
title_fullStr	Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study
title_full_unstemmed	Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study
title_sort	barriers and facilitators to facility hiv self-testing in outpatient settings in malawi: a qualitative study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/18e55f5f9e074fc8af55951874ba7832
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Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study

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