Knowing Myself First assessed the feasibility of free, home-based HIV self-testing for health workers in Kenya, for whom HIV infection is an occupational risk.
For health care workers in Kenya, HIV infection is an occupational risk because of their frequent handling of needles and bodily fluids. Yet preliminary surveys revealed that health care workers were not seeking routine HIV counseling and testing—a consequence of the same barriers experienced by the general population, including stigma, discrimination, and lack of confidentiality.
The Population Council piloted and evaluated the acceptability and feasibility of “Knowing Myself First,” an intervention that offered free, home-based HIV self-testing for health care workers in Kenya.
The intervention targeted district-level hospital clinicians and counselors, including doctors, nurses, laboratory technicians, counselors, and social workers. Health care workers interested in self-testing attended required information sessions in small groups and then received free oral HIV test kits. Post-testing counseling and information were offered by mobile and site-based HIV counselors, as well as through a toll-free counseling hotline.
Approximately 90% of health workers who attended an information session took a testing kit with them after the session. The majority (85%) tested themselves, with 72% testing themselves within one day. Additionally, 64% of the health workers with sexual partners indicated that their partners used the kits to test themselves. Qualitative results revealed that while many of the health workers and their partners tested together, those couples who did not do so still revealed test results to their partners.
The study indicated that health workers and their partners understand the need to test themselves for HIV. The greater hurdle to acceptance of self-testing was getting the health workers to attend the information sessions, rather than use of the kits. Another major gap was the need for post-test counseling and follow-up care and support services for health workers who test HIV-positive.
The study demonstrated that HIV self-testing can be successfully implemented among hospital-based health care workers, and given the high demand for HIV self-testing, self-test kits must be made available on a larger scale. Results informed the scale-up of the intervention to seven other district-level hospitals across Kenya.