Population Council Research that makes a difference

Abstract

Feasibility and acceptability of HIV self-testing among healthcare workers: Results of a pilot program in two hospitals in Kenya 
Oral poster discussion at the XVIII International AIDS Conference, Vienna, 21 July
Kalibala,Sam; Tun,Waimar; Muraah,William; Cherutich,Peter; Bunnell,Becky; Oluoch,Patricia; Marum,Lawrence
Publication date: 2010


Background
Healthcare workers (HCWs) are highly vulnerable to occupational exposure to HIV. Yet many often do not get tested for HIV due to concerns about confidentiality and stigma. Interventions are needed to reduce barriers for HCWs to be tested for HIV. We evaluated the acceptability and feasibility of a free home-based HIV self-testing (HST) intervention for HCWs.

Methods
A one-month pilot was implemented in two hospitals in Kenya. HCWs participated in pre-HST information session, and HST kits (oral tests) were provided free of charge for themselves and their partners. Pre- and post-test counseling was available through a toll-free hotline and on-site HIV counselors. Focus group discussions (N=5) with 50 HST kit recipients and interviews (N=5) with program coordinators and hospital managers were conducted to understand experiences with and perceptions of HST.

Results
Of 295 HCWs, 70 percent (n=207) attended the pre-HST information session, and 93 percent (192/295) accepted HST kits. An additional 38 HCWs took kits from on-site coordinators yielding an overall acceptance rate of 78 percent (230/295). Focus group discussion results revealed that almost all HCWs who took an HST kit actually tested, and the majority tested themselves within one week of receiving the kit. They found the kit convenient as it can easily be hidden inside a pocket. The majority of HCWs reported preference to confirm results at a VCT center. Some actually confirmed their results using an HST kit. Although participants felt the hotline was useful, only a few actually used the hotline. The majority of calls were for clarification on proper sample collection.

Conclusions
HIV self-testing can be successfully implemented among hospital-based HCWs. These results suggest that there is high demand for HST, and self-tests kits must be made available on a larger scale. This intervention is currently being scaled up in seven additional hospitals. Lessons learned from the expansion will be described.