Providing HIV self-testing kits to pregnant women to encourage HIV testing in their male partners is acceptable to men and women in Uganda, but women who are apprehensive about their partners’ reactions may need more support, according to findings from a qualitative study of participants in a randomised trial of the strategy published in the journal Global Health Action.
Self-testing for HIV permits people to test for HIV away from health facilities, in the privacy of their own homes or elsewhere, at a time of their own choosing. For these reasons, self-testing has the potential to improve testing rates in 'hard-to-reach' groups such as male partners of women attending antenatal clinics. There has been extremely low uptake when male partners have been given invitations to attend testing facilities, but testing rates have been improved by giving testing kits to women to pass on to their partners.
The qualitative study formed part of a pilot, cluster-randomised trial of an intervention to improve HIV testing rates in male partners of women attending antenatal services at three hospitals in central Uganda, using oral HIV self-testing kits. Women in the self-testing kit arm were given two to four self-testing kits, including one for themselves, one for their male partners and kits for any other adults in the household. They also received training in how to carry out the test and read the result. They took part in role-plays in how they could deliver the kits and persuade their partner to use them.
In-depth interviews were conducted with 17 women who had taken part in the study and 15 male partners who had agreed to use the self-testing kit. The interviews explored their perceptions of HIV self-testing as a testing strategy, the strategies used by women to deliver the testing kits to their partners and to persuade them to use the kits, and post-test experiences after using the kits.
Five interviewees were in concordant HIV-positive relationships, nine in HIV-discordant relationships and 18 in concordant HIV-negative relationships.