“They have given you the morale and confidence:” adolescents and young adults want more community-based oral HIV self-testing options in Kenya

ABSTRACT

Community-based delivery of oral HIV self-testing (HIVST) may expand access to testing among adolescents and young adults (AYA). Eliciting youth perspectives can help to optimize these services. We conducted nine focus group discussions (FGDs) with HIV negative AYA aged 15–24 who had completed oral HIVST following community-based distribution through homes, pharmacies, and bars. FGDs were stratified by distribution point and age (15–17, 18–24). Participants valued HIVST because it promoted greater autonomy and convenience compared to traditional clinic-based testing. AYA noted how HIVST could encourage positive behavior change, including using condoms to remain HIV negative. Participants recommended that future testing strategies include individualized, ongoing support during and after testing. Support examples included access to trained peer educators, multiple community-based distribution points, and post-test support via phones and websites. Multiple distribution points and trained peer educators’ involvement in all steps of distribution, testing, and follow-up can enhance future community-based HIVST programs.

KEYWORDS:

• Adolescent HIV
• qualitative research
• HIV self-testing

Acknowledgements

Kate Wilson designed the study. Hellen Moraa, Vivianne Manyeki, and Carol Mung’ala, collected the data. Robert Lapsley, Hellen Moraa, Kristin Beima-Sofie, and Kate Wilson conducted the analysis. Robert Lapsley, Kristin Beima-Sofie, and Kate Wilson wrote the manuscript. All authors reviewed and approved the final manuscript. We gratefully acknowledge the time and contribution of YES study participants and the study team. We would like to thank Christine Kundu for assistance with translations, the CFAR Behavioral Science Core Qualitative Working Group (JIG-Q, P30 AI027757) for feedback and guidance on qualitative methods, and our collaborators (LVCT Health, National AIDS and STI Control Programme, Kenyatta National Hospital) for their support and guidance.

Disclosure statement

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

Data availability statement

De-identified data can be made available upon request.

Additional information

Funding

This work was supported by the National Institutes of Health [grant number P30 A1027757, PI: Celum]