Background
Methods
Study design and procedures
Interview guide
Data analysis
Ethical approval
Results
Participants characteristics
n | % | |
---|---|---|
Total | 65 | 100.0 |
Age, years mean (SD) | 21.2 | (2.6) |
Sex | ||
Male | 28 | 43.1 |
Female | 37 | 56.9 |
Marital Status | ||
Single | 61 | 93.8 |
Married/Engaged | 2 | 3.1 |
Ethnic Group | ||
Yoruba | 39 | 60.0 |
Igbo | 17 | 26.2 |
Others | 8 | 12.3 |
Religion | ||
Christian | 47 | 72.3 |
Muslim | 15 | 23.1 |
Others | 1 | 1.5 |
Highest Level of Education | ||
Primary | 5 | 7.7 |
Secondary | 53 | 81.5 |
Higher than secondary | 3 | 4.6 |
Occupation | ||
Employed | 2 | 3.1 |
Self-employed | 2 | 3.1 |
Unemployed student | 57 | 87.7 |
Ever Tested for HIV | ||
Yes | 43 | 66.2 |
No | 17 | 26.2 |
Ever Heard of HIV Self-testing | ||
Yes | 2 | 3.1 |
No | 63 | 96.9 |
Individual level characteristics - perceived facilitators of HIV self-testing
If we had an HIV testing kit like a pregnancy test, it would be very good because I could just get a kit, do it in the confines of my room and then nobody’s judging me, nobody’s giving me this look, like “Maybe she’s done something. Why does she want to know her status?” (#65, Female, ever tested for HIV)
“You could walk into any pharmacy or store and get it [HIVST kit], that's like the best thing that could happen right now because it reduces the chances of discrimination and stigmatization. Because in the society that we live in right now, even without people knowing your actual status, they get to discriminate just because you're getting tested in the first place, and that alone brings fear to the minds of people.” (#65, Female, ever tested for HIV)
“this is something [HIVST] that I could buy at the pharmacy when I want and I can do it within a confined space… it will also save me the stress of going to the hospital or waiting for one of those tents to be set up at an awareness event whenever they decide to. It gives me convenience.”(#08, Male, never tested for HIV)
“if you create the kits, it will make more people come out to check for their status, and then prevent [HIV] too because if people do not know their status, they won't be able to get the necessary treatment. So, if I could check it myself, I definitely could get the right treatment for it”. (#61, Female, ever tested for HIV)
“let's say for a girl and boy, they're about to have sex if you meet a girl in a night club and ask what is your HIV status, you already seem unsure but this is very fast and you can use this to know if the person is HIV positive” (#02, Male, ever tested for HIV)
“before you have sex with your partner, at least you may say, “Okay, let’s just do this [HIVST]. Let me feel comfortable.” And show, the HIV test result first” (#21, Female, ever tested for HIV
Individual level characteristics - perceived barriers to HIV self-testing
“[after using the HIVST kit] if he/she finds out they have HIV, number one the person may not tell anybody and then the person may go into depression and maybe start doing drugs or doing other things or this person may just go and kill himself.” (#10, Female, never tested for HIV)
“Are there any directions? I don't mean how to use it. If I test and I don't commit suicide, how will I get medical advice? Do I just walk to the hospital and tell them? Because I mean that is very hard to just walk into the hospital and tell them.” (#02, Male, ever tested for HIV)
“I prefer going to the hospital … Because I would know much better. I don’t know if the kit would show me the correct result, or not.” (#64, Female, ever tested for HIV)
“I just feel as though a professional should be there … It just seems as if there should be at least a level of know-how in doing it [HIVST], I just feel like somebody might get themselves injured or maybe go about it the wrong way” (#08, Male, never tested for HIV)
Test level characteristics – costs, testing method and nature of packaging
The oral-based HIVST was preferred by most of the participants when compared to the blood-based HIV test conducted by a health worker or tester, due to fear of pain and discomfort from the needle pricking. Some participants shared the following:“If it's overly expensive most people would not want to patronize it because getting tested right now at some facilities is free. In some facilities, it is as low as 500 naira or 1,000 naira in Nigeria right now. So, if it's not so expensive, people would prefer this [HIVST] than walking into facilities” (#65, Female, ever tested for HIV)
“Most people, like myself, have a phobia of needles and even going to hospital to get treatment and all that, they don't really like the idea of injections. For example, my cousin, would rather take any medication than to go to the hospital to get pricked by a needle. So, I think I'll prefer using a swab in the mouth to test for HIV..” (#65, Female, ever tested for HIV)
“you won't have to stress yourself going to the hospital, injecting a needle in you to drain out your blood. And after that, you will still be waiting for the results to come out.” (#37, Female, ever tested for HIV)
Whereas, few preferred a total package in the form of a prevention box that will include the HIVST kit, condoms, pregnancy test kit, lubricants, other STI test kits, malaria, and tuberculosis test kits:“So it’s too naked and it doesn’t say much … it’s not something that I want to buy to use. It’s too, can I use the word vague? I think there needs to be words on the packaging. Add some colors!” (#02, Male, ever tested for HIV)
“if there were kits that included something to test for an STI and something to test for HIV as well, that works … they could make it a total package and even have a pregnancy in there as well…” (#65, Female, ever tested for HIV)
“I would also like tuberculosis [kit]. It has to be inside [the box] because tuberculosis and HIV kind of go hand in hand sometimes”. (#26, Female, ever tested for HIV)
Service delivery level characteristics – testing experiences, access locations, continuing care and support
“Because maybe I will get infected since they are going to use a needle and inject me, so there is fear that the needle will get infected … I am scared that [the needle] it’s not sterile … ” (#46, Male, never tested for HIV)
“Pharmacies could sell it as well, but not these, kind of small, small, pharmacies, like chemist shop, I mean well-recognized pharmacy should sell this Oraquick HIV test.” (#51, Female, ever tested for HIV)
“if there's like a number or a helpline, maybe toll-free. I prefer toll free so I can talk to the person and the person still gives me some insight on how to go about it…” (#02, Male, ever tested for HIV)
“Maybe a general healthcare line that a person could call and then be referred to a close healthcare center around your place” (#65, Female, ever tested for HIV)
“As a young person I would want to live as long as I can with the disease so that alone can spur me to want to go for confirmation and also the slightest chance that maybe the first test was wrong in the hope, probably would spur me to go for the confirmation test” (#01, Male, ever tested for HIV)
“Because I might not be that satisfied that I'm positive, first time using the HIVST, but I might think maybe it's not true, maybe it's giving me wrong details.” (#45, Male, ever tested for HIV)
“I prefer one-on-one [HIV testing] rather than test in cliques … ” (#54, Female, ever tested for HIV)
“Most people would just prefer to do it [HIV self-test] privately. I think I would prefer to do it privately, and then if it comes out positive or negative, I'll determine who I get to tell or who should know about it” (#65, Female, ever tested for HIV)