Adolescents’ and caregivers’ perceptions of caregiver-provided testing and HIV self-testing using oral mucosal transudate tests in Zimbabwe: a short report

ABSTRACT

Uptake of HIV testing remains lower among children and adolescents compared to adults. This study explored adolescents’ perceptions of HIV self-testing (HIVST) and caregivers’ perceptions of testing their children using an oral mucosal transudate (OMT) rapid HIV test (caregiver-provided testing). We conducted 31 interviews with adolescents aged 16–18 years and caregivers of children aged 2–15 years who received an OMT test. Participants described barriers to HIV testing including lack of privacy and the potential for discrimination by community members towards children and adolescents who received an HIV test. Most participants felt caregiver-provided testing and HIVST could address these barriers through increased privacy. Some participants expressed worry about their ability to correctly perform the OMT and their anxious reactions to a positive result. Counseling and assistance from health care workers were viewed as ways to alleviate concerns. Concerns shaped participants’ preferences for facility-based HIVST and caregiver-provided testing. Findings demonstrate HIVST performed by adolescents and caregiver-provided testing could increase the uptake of HIV testing. Concerns related to being able to test correctly and the availability of post-test counseling must be addressed in any future delivery mechanisms.

KEYWORDS:

• HIV
• oral mucosal transudate tests
• HIV self-testing
• children
• adolescents
• Africa

Acknowledgements

We would like to thank the caregivers and adolescents who contributed their time to participate in this study and thank the staff at Parirenyatwa Hospital and Harare Central Hospital for their invaluable support during the study. We would also like to thank Evangelia (Evi) Alexopoulos for her help in organizing, reviewing, and coding the interview data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was funded by the UK Medical Research Council (MRC) and the Department for International Development UK under the MRC/DFID Concordat agreement and is also part of the EDCTP2 programme supported by the European Union grant [grant number MR/P011268/1]. A portion of this study was jointly funded by a Duke Global Health Institute student fieldwork grant, Duke University International and Global Studies Graduate Award for Research and Training, and a Duke Arts and Sciences Faculty Grant. RAF is funded by the Wellcome Trust through a Senior Fellowship in Clinical Science [grant number 206316/Z/17/Z].