Acceptability and accessibility of HIV testing and treatment among men who have sex with men in Botswana

Abstract

Background: Although HIV testing and treatment are the cornerstones of a comprehensive prevention strategy, their acceptability and accessibility are complex within the healthcare system. Methods: We used Aday and Andersen’s conceptual framework of access to healthcare services to explore factors influencing acceptability and accessibility of HIV testing and treatment among men who have sex with men (MSM) in Botswana. A qualitative descriptive study was conducted, using purposive sampling to recruit 20 MSM. Semi-structured interviews were conducted in Setswana and English. All data were audio-recorded, transcribed, translated into English, where necessary, and analysed using thematic analysis. Findings: This study found that acceptance of HIV testing and treatment was largely positive among MSM. Motivators were the expansion of HIV services, free healthcare services and the perceived risk of contracting HIV. Although perceptions of accessibility to HIV testing and treatment were positive, there were some concerns about privacy and confidentiality, perceived barriers and fear of positive diagnosis, making MSM reluctant to access HIV testing and treatment. Conclusion: This study highlights the need for novel approaches to increase the acceptability and accessibility of HIV testing and treatment. Barriers to accessing HIV services should be addressed to achieve satisfactory health outcomes, and sustainable HIV prevention barriers to accessing HIV should be addressed among MSM.