Operationalizing the distribution of oral HIV self-testing kits to men who have sex with men (MSM) in a highly homophobic environment: the Nigerian experience

Adekemi Sekoni,Lung Vu,Waimar Tun,Folasade Ogunsola,Temitope Ladi-Akinyemi,Osasuyi Dirisu,Elizabeth Shoyemi,Sylvia Adebajo

doi:10.1186/s12889-021-12378-0

Abstract

BackgroundSelf-care health interventions are innovative approaches for improving health and achieving the sustainable development goals (SDGs). Men who have sex with men (MSM) have been disproportionately affected by Human Immunodeficiency Virus (HIV). In spite of this, stigma from healthcare workers has reportedly prevented MSM from accessing HIV testing in health facilities. This paper explored the operationalization of using key opinion leaders (KOLs) to distribute HIVST (HIV self-test) kits to MSM. This qualitative survey used a combination of in-depth interviews (IDI) with HIVST users and focus group discussions (FGDs) with KOLs to collect data three months after the distribution of the test kits by the KOLs. Thematic analysis of the data was carried out.ResultThree themes were generated namely: KOLs serve as a trusted resource to promote and support HIVST for the MSM community; Skills and qualifications required for KOLs to effectively distribute and promote uptake of HIVST; and Effective strategies used to create demand and promote uptake of HIVST.ConclusionThis study showed the practical steps involved in operationalizing KOL support system distribution of HIVST that positively influenced the testing experience for the participants irrespective of the HIV status and engagement in care. KOLs are a reliable resource to leverage for ensuring that HIV self-test kit is utilized and HIV positive individuals are linked to treatment and care in homophobic environments.

Highlights

In several countries, available evidence suggests a high prevalence of Human Immunodeficiency Virus (HIV) infection among men who have sex with men (13% in Togo; 17% in Nigeria; 22% in Tanzania) [1,2,3]
This study showed the practical steps involved in operationalizing key opinion leaders (KOLs) support system distribution of HIV self-testing (HIVST) that positively influenced the testing experience for the participants irrespective of the HIV status and engage‐ ment in care
KOLs are a reliable resource to leverage for ensuring that HIV self-test kit is utilized and HIV positive individuals are linked to treatment and care in homophobic environments

Summary

Introduction

Available evidence suggests a high prevalence of HIV infection among men who have sex with men (13% in Togo; 17% in Nigeria; 22% in Tanzania) [1,2,3]. Since the passing of this law, the social environment in Nigeria became more hostile [13] The effect of this law spilt over into health services resulting in discrimination by healthcare providers [14] and subsequently a reduction in uptake of HIVrelated prevention, treatment and care services in health facilities [15]. This paper explored the operationalization of using key opinion leaders (KOLs) to distribute HIVST (HIV self-test) kits to MSM. This qualitative survey used a combination of in-depth interviews (IDI) with HIVST users and focus group discussions (FGDs) with KOLs to collect data three months after the distribution of the test kits by the KOLs. Thematic analysis of the data was carried out

Methods

Results

Discussion

Conclusion