20th International AIDS Conference - Melbourne, Australia


WEAX0101 - Oral Abstract

“I think it is right”: Acceptability of an HIV self-test by lay users in KwaZulu-Natal, South Africa

Presented by Lucia Knight (South Africa).

L. Knight1, H. van Rooyen2, J. Lim3, R. Peck3

1Human Sciences Research Council, HIV/AIDS, STIs and TB Unit, Durban, South Africa, 2Human Sciences Research Council, HIV/AIDS, STIs and TB Unit, Pietermaritzburg, South Africa, 3Program for Appropriate Technology in Health, Seattle, United States

Background: Although the uptake of HIV testing has increased in sub-Sahara Africa, the proportion of people aware of their HIV status remains lower than required to change the pandemic. Self-testing (ST) may improve uptake. But assessment of readiness for and the acceptability of self-tests by lay users in South Africa is limited. This paper presents results from a formative study designed to assess the acceptability of self-test prototypes among lay users.
Methods: This study tested the acceptability and usability of several early self-test prototypes, although only acceptability results are presented here. Fifty lay users were purposively selected in rural KwaZulu-Natal, South Africa to represent the community''s geographic, social and demographic profile. The acceptability of ST was assessed using a simple post-test quantitative assessment addressing ease of and confidence with use, future use of a test if available and/or free and willingness to buy. Qualitative interviews explored in-depth what people liked about the self-test and why, their willingness to recommend and how much they would pay for a test.
Results: Regardless of prototype and problems with test use, the response to both ease of use (80%) and qualitative assessment of likability were overwhelmingly positive. Reasons for this included privacy and autonomy, removing the barriers presented by the clinic and ensuring confidentiality. In addition, the majority of respondents would choose to conduct the test again if it was free (98%) with most being willing to buy a test (86%). Some stated they would require better instructions and a more usable test. Most people would recommend self-test use to others.
Conclusions: The results from this study begin to point to high acceptability and interest in HIV self-testing among lay users in a community in KwaZulu-Natal. Although the broader study raises concerns about test usability and a need for further research to address this, the positive response and readiness amongst lay users for an HIV self-test in this rural community within South Africa suggests that there would be a ready and willing market for HIV self-tests.

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