Family-Based Index testing for HIV; a qualitative study of acceptance, barriers/challenges and facilitators among clients in Cape Coast, Ghana

ABSTRACT

Family-based Index HIV Testing, (FBIT) approach is known to be associated with a relatively higher testing yield compared to Provider-Initiated Testing and Counselling. The implementation of this strategy in several countries has exposed some barriers to optimal FBIT outcomes. With the scale up of FBIT in Ghana, stakeholder engagement is key in identifying and addressing barriers to implementation. This study explored acceptance, barriers/challenges and facilitators of FBIT. Seventeen in-depth qualitative interviews were conducted among clients who had been offered FBIT at the Cape Coast Teaching Hospital using a semi-structured interview guide. Data were analysed using Braun and Clarke’s [(2006)] thematic analysis framework and found that (1) participants accepted the strategy and were willing to use it; (2) lack of awareness of the strategy among the general public, fear of disclosure/stigmatization, issues with confidentiality and privacy are barriers/challenges associated with the FBIT approach, and (3) increasing public education on HIV in general and FBIT in particular, ensuring confidentiality and privacy regarding testing are facilitators for increasing uptake of FBIT. It is concluded that despite acceptance of FBIT as a good strategy among index clients, general HIV education to reduce stigma and addressing confidentiality can optimize uptake.

KEYWORDS:

• Family
• HIV testing
• barriers
• challenges
• facilitators
• stigma
• Ghana
• Cape Coast

Acknowledgements

We acknowledge the support of staff and index patients of the HIV Clinic of CCTH. Sincere thanks to Mr Attuah Agyekum and Miss. Sarah Nsowah for helping with data collection. Authors’ contributions: EAA and DOY conceptualized the topic and were involved in the design, data collection analysis and drafting of the manuscript. ICT, EA and NIEE contributed to the design of the topic, data collection and review of the manuscript. RAG and SAA contributed to the study design and review of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

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

Additional information

Funding

Funding for this research was by the Directorate of Research, Innovation and Consultancy -University of Cape Coast, Ghana (DRIC-UCC). The Research Support Grant identification number is RSG/GRP/CoHAS/2019/107. The funder had no influence on the data collection, analysis and any aspect of this study.