What do Key Stakeholders Think About HIV Self-Testing in Canada? Results from a Cross-Sectional Survey

N. Pant Pai, M. Smallwood, D. Gulati, N. Lapczak, A. Musten, C. Gaydos, C. Johnston, M. Steben, T. Wong, N. Engel, J. Kim

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Human immunodeficiency virus (HIV) self-testing presents an empowering alternative to facility-based testing for reaching undiagnosed HIV infected individuals, but is not currently available in Canada. We surveyed stakeholders (clinical providers, public health professionals, researchers) engaged in HIV testing initiatives nationwide to identify the concerns, opportunities and challenges to implementing HIV self-testing in Canada. An online cross-sectional survey was disseminated by the Canadian Institutes of Health Research Centre for REACH 2.0 National HIV & sexually transmitted and blood borne infections working group to stakeholders nationwide, with a target sample size of 200. Quantitative and qualitative data were analyzed using a mixed-methods, respondent-informed approach, to inform subsequent HIV self-testing in a country where self-testing is not yet accessible. A total of 183 responses were received. A majority (70.7%) (128/181) felt that self-testing was a necessary investment to reach the undiagnosed. 64.6% (117/181) felt that self-tests should be made available to their clients and 71.5% (128/179) of respondents agreed that self-test instructions required improvements. However, 50% (90/180) felt that self-testing will pose an economic challenge to current HIV testing models. Regardless, 21% urged for timely action and availability of HIV self-tests. Thematic analyses reflected the following concerns: (a) need for affordable self-tests, (b) need for expedited, customized, and accessible linkages to counselling, (c) concern for patients to cope with positive self-test results, (d) accuracy of self-tests to detect acute HIV and (e) liability in the context of non-disclosure. Stakeholders agreed to the provision of an option of HIV self-testing to reach the undiagnosed individuals. Concerns regarding costs and accuracy of self-tests, expedited linkages to counselling, and integration of self-test within prevailing HIV testing models, will need to be addressed before their widespread implementation.
Original languageEnglish
Pages (from-to)606-615
JournalAIDS and Behavior
Volume22
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018
Externally publishedYes

Funding

Conceived and designed the study: NPP, MS, DG, NL, AM, NE, JK. Conducted the study: NPP, MS, NL, DG, NE, JK, CG, CJ, MS, TW. Analyzed the data: All authors. Contributed materials/analysis tools: NPP, NE, JK, AM, CG, CJ, TW, MS, DG. Wrote the paper: All authors. This work was funded by the Canadian Institutes for Health Research (CIHR) grant No HIB-131558. The funding agency had no involvement in the design, conduct, writing, or analysis of this study, or in the decision to submit this manuscript for publication. Funding This work was funded by the Canadian Institutes for Health Research (CIHR) grant No HIB-131558. The funding agency had no involvement in the design, conduct, writing, or analysis of this study, or in the decision to submit this manuscript for publication.

FundersFunder number
Office of Nuclear Energy
Canadian Institutes of Health ResearchHIB-131558
Canadian Institutes of Health Research

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