Facility human immunodeficiency virus self–testing (HIVST) in outpatient departments (OPD) while patients wait for routine care could increase HIV testing coverage with minimal time required from health care workers. In a report in BMC Public Health, Mischek Mphande and colleagues presented data on barriers and facilitators to patients’ use of facility HIVST. They observed that using OPD waiting spaces for test kit distribution, along with private spaces for test interpretation, led facility HIVST to be largely accepted and feasible in an outpatient population of adults in Malawi.

The study’s findings were based on in–depth interviews of 57 patients who were provided with HIVST intervention, as well as observational journals from study staff in waiting spaces where HIVST was implemented.

Their report stated that facility self–testing was “convenient, fast, and provided autonomy” for patients. Specifically, the researchers noted that “increased motivation to test due to seeing others test, immediate support for HIVST use, and easy access to additional HIV services in the health facility,” were HIVST facilitators unique to OPD settings.

Conversely, barriers to facility HIVST acceptance included fear of judgement from others and fear of unwanted disclosure of HIV status due to lack of privacy. Requested intervention changes desired by outpatients included separate spaces for kit use and interpretation, and increased opportunity for disclosure and counseling.

Mphande and contributors had a largely positive view of facility HIVST implementation, given the promising facilitators unique to the facility OPD setting. They advised that “strategies to promote privacy throughout the HIVST process, to improve disclosure of test results to HCWs, and to strengthen post-test counseling are important areas for future research.”


Source: BMC Public Health