‘When I have these kits … I have confidence’ – HIV self-testing provides agency for women in their sexual decision-making

摘要

Oral fluid-based HIV self-testing (HIVST) has emerged as a promisingapproach to increasing HIV testing coverage, particularly among highriskpopulations. Understanding the experiences of women using selftestsand offering them to their sexual partners (secondary distribution)is crucial for determining the potential of HIVST. Qualitative in-depthinterviews were conducted among 32 women at high risk of HIVinfection, including women who engage in transactional sex, whoparticipated in a cluster randomised trial of a secondary distributionstrategy in western Kenya. Interviews explored how women used selftestswithin relationships and how this affected their sexual decisionmaking.Three key themes emerged: women used HIVST to assess riskprior to engaging in sex with partners; HIVST provided women withincreased agency to engage in or end relationships; and womenappreciated these benefits and urged expanded access to self-tests.HIVST has the potential to support HIV prevention objectives in settingswith high prevalence of HIV.