Repeat HIV testing practices in the era of HIV self-testing among adults in KwaZulu-Natal, South Africa.

Charlene Harichund,Mosa Moshabela,Quarraisha Abdool Karim,Sinenhlanhla Simelane,Pinky Kunene,Jonathan Garcia

doi:10.1371/journal.pone.0212343

Abstract

Repeat HIV testing is important in high HIV burden communities to enable sustainability of prevention initiatives; however, an understanding of repeat testing practices is limited. Additional HIV testing approaches may be required to increase testing. HIV self-testing is an additional testing approach, but knowledge on its potential for repeat testing is limited. This study explored repeat HIV testing practices and uptake of HIV self-testing among repeat testers, following exposure to HIV self-testing. HIV testing practices were explored at two time points. During Phase 1, eighty in-depth interviews were conducted among 40 consenting adults, and 30 telephonic contacts were completed during Phase 2. Framework analysis was used to analyse the transcripts from the in-depth interviews. The practice of repeat HIV testing is primarily influenced by HIV status awareness and risk exposure. Thirteen regular testers and one HIV naïve tester at baseline had undergone repeat testing through the use of a traditional testing approach such as HIV counselling and testing as reported in Phase 2. HIV self-testing has a role among repeat testers, but affordability and access are barriers.

Highlights

Despite the availability of several HIV testing approaches, HIV counselling and testing (HCT) is most commonly utilized and has utility for people who test for the first time [1, 2]
The World Health Organization (WHO) recommends HIV selftesting (HIVST) as an additional HIV testing approach, to complement existing services associated with HCT [4]
This study focused on motivation to test for HIV and preference for HCT or HIVST as a testing approach, but did not explore cost and accessibility of HIVST which are characteristic of feasibility studies

Summary

Introduction

Despite the availability of several HIV testing approaches, HIV counselling and testing (HCT) is most commonly utilized and has utility for people who test for the first time [1, 2]. Repeat HIV testing practice and potential role of HIV self-testing men who have sex with men (MSM) and male partners of heterosexual women, was recently reviewed [5]. While the uptake of HIV testing is primarily focused on individuals who test for the first time, enabling earlier diagnosis and management of participants, there is little data available on repeat HIV testing [6]. Repeat HIV testing is important, for individuals in high HIV burden communities, and where partner change is frequent but safer sex practices are limited for multiple reasons [1, 7]. Repeat HIV testing is important as it ensures sustainability and the continued success of prevention programmes [8]

Methods

Discussion

Conclusion