Abstract
BackgroundThe Philippines is facing a rapidly rising HIV epidemic among young men who have sex with men (MSM). Testing rates among young populations is poor. HIV self-testing (HIVST) is a promising strategy to address this testing gap. The study’s purpose was to explore the perceived acceptability, feasibility and programmatic challenges of HIVST among key informants and target users.MethodA qualitative study involving semi-structured interviews and focus group discussions (FGD). We interviewed 15 key informants involved with HIV testing programs or policies and 42 target users in six FGD in Metro Manila. We held separate discussions with high socio-economic MSM (n = 12), urban poor MSM (n = 15) and transgender women (TGW) (n = 15). Results were analysed using a thematic framework approach.ResultsMSM and TGW welcomed the convenience and privacy HIVST could provide. They preferred an inexpensive accurate blood-based kit attained from reputable sites. Key informants at national and local level equally welcomed HIVST but identified a number of policy and regulatory issues. Both groups articulated the challenge of enrolling those who test reactive using HIVST to further testing and treatment in an environment characterised by acute stigma around HIV.ConclusionsHIVST was found to be highly acceptable to target users and was welcomed as an additional testing approach at national level. Strategic alliances are now needed between stakeholders to proactively deliver a patient-centred HIVST program that could provide an effective, safe means of increasing testing coverage in this escalating context.
Highlights
The Philippines is facing a rapidly rising Human immunodeficiency Virus (HIV) epidemic among young men who have sex with men (MSM)
MSM and transgender women (TGW) welcomed the idea of introducing HIV self-testing (HIVST), especially blood-based diagnostic kits, accessed via reputable outlets
HIVST: big benefits and high demand from target users and key informants HIVST availability was considered by all participants as being a beneficial addition to the HIV testing strategy in the Philippines, in reaching high-risk groups such as young MSM
Summary
The Philippines is facing a rapidly rising HIV epidemic among young men who have sex with men (MSM). The Philippines is experiencing the most rapidly escalating HIV epidemic in the world [1]. A concentrated epidemic exists among men who have sex with men (MSM) and transgender women (TGW), with eight regions having a prevalence above 5% in these groups [3]. Specific data for TGW are limited [4], a cross-sectional study in Cebu City in 2015 showed a 11.8% HIV prevalence in this group [5]. There is currently a large unmet need for HIV testing among both MSM and TGW. An estimated 63% of MSM and TGW living with HIV diagnosed; disaggregating further into age groups surfaces the disadvantageous position of young key
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