Men’s perceptions of HIV self-testing in Eswatini: a qualitative study

ABSTRACT

Men in Eswatini test for HIV at lower rates compared to women despite the widespread availability of HIV testing services in the country. HIV self-test kits have been proposed as an HIV testing model to reach more men by bypassing the health facility, which is known to be a barrier for men using HIV testing services. In this study, we sought to understand men’s perspectives on HIV self-testing in Eswatini. We conducted semi-structured interviews with 22 men, recruited from a rural community and from an urban men’s clinic, to assess their awareness of HIV self-testing and their perceptions of it as an alternative HIV testing option. Findings show that men were aware of HIV self-testing but had concerns that left most feeling hesitant about adopting it. Many men expressed doubts about the accuracy of self-testing and their own technical competence to use the kit without supervision. They also expressed fears about testing, and possibly learning they were HIV positive, without adequate pre – and post-HIV test counseling. To allay men’s fears and improve uptake of HIV self-testing, practitioners might consider innovative methods such as virtual counseling services and linking HIV self-testing to other community-based HIV care services.

KEYWORDS:

• HIV testing
• men
• HIVST

Sustainable Development Goals:

• SDG 3: Good health and well-being

Acknowledgements

We thank the participants who contributed to this research for sharing their intimate stories and perspectives on HIV testing. Sincere gratitude also goes towards clinic staff for hosting the first author during fieldwork. Authors’ contributions: Study design (all authors) data collection and initial analysis (first author), drafting of manuscript (all authors), critical revision of manuscript (all authors), and final approval of submitted version (all authors).

Disclosure statement

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

Ethics approval

Ethics approval was granted by the Colorado Multiple Institute Review Board (COMIRB #22-0762) and the Eswatini Health and Human Research Review Board (EHHRRB 049/2022).

Availability of data and material

Data presented in this work may be available from the first author upon direct request.

Additional information

Funding

This work was funded by the Department of Health and Behavioral Sciences Research Fellowship Grant at the University of Colorado Denver.