Adolescents’ and caregivers’ perceptions of caregiver-provided testing and HIV self-testing using oral mucosal transudate tests in Zimbabwe: a short report

Crissi Rainer,Belinda Chihota,Chido Dziva Chikwari,Grace Mchugh,Ethel Dauya,Hilda Mujuru,Rashida A Ferrand,Kearsley A Stewart

doi:10.1080/09540121.2020.1749226

Abstract

ABSTRACT Uptake of HIV testing remains lower among children and adolescents compared to adults. This study explored adolescents’ perceptions of HIV self-testing (HIVST) and caregivers’ perceptions of testing their children using an oral mucosal transudate (OMT) rapid HIV test (caregiver-provided testing). We conducted 31 interviews with adolescents aged 16–18 years and caregivers of children aged 2–15 years who received an OMT test. Participants described barriers to HIV testing including lack of privacy and the potential for discrimination by community members towards children and adolescents who received an HIV test. Most participants felt caregiver-provided testing and HIVST could address these barriers through increased privacy. Some participants expressed worry about their ability to correctly perform the OMT and their anxious reactions to a positive result. Counseling and assistance from health care workers were viewed as ways to alleviate concerns. Concerns shaped participants’ preferences for facility-based HIVST and caregiver-provided testing. Findings demonstrate HIVST performed by adolescents and caregiver-provided testing could increase the uptake of HIV testing. Concerns related to being able to test correctly and the availability of post-test counseling must be addressed in any future delivery mechanisms.

Highlights

HIV testing is the critical entry point to accessing HIV care and prevention services
Children and adolescents face additional barriers to HIV testing including fear of the perceived stigma associated with testing, fear of discrimination from health care workers (HCWs), fear of their caregiver’s reaction to seeking testing, and need for guardian consent (Kranzer et al, 2014; WHO, 2013)
This study shows that caregiver-provided testing and HIV self-testing (HIVST) could indirectly address the fear of discrimination by giving caregivers and adolescents greater privacy and control over others’ knowledge of their status (Napierala Mavedzenge et al, 2013)

Summary

Introduction

HIV testing is the critical entry point to accessing HIV care and prevention services. Children and adolescents face additional barriers to HIV testing including fear of the perceived stigma associated with testing, fear of discrimination from health care workers (HCWs), fear of their caregiver’s reaction to seeking testing, and need for guardian consent (Kranzer et al, 2014; WHO, 2013). Given these barriers, novel HIV testing and counseling (HTC) approaches are needed to increase uptake of HIV testing.

Methods

Results

Conclusion