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What are the constraints and opportunities for HIVST scale-up in Africa?: evidence from Kenya, Malawi and South Africa

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dc.date.accessioned 2015-03-23 en
dc.date.accessioned 2021-02-09T15:25:13Z
dc.date.available 2021-02-09T15:25:13Z
dc.date.issued 2015-08-25 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/2009
dc.description.abstract HIV self-testing (HIVST) has the potential to increase uptake of HIV testing among untested populations in sub-Saharan Africa and is on the brink of scale-up. However, it is unclear to what extent HIVST would be supported by stakeholders, what policy frameworks are in place and how variations between contexts might influence country-preparedness for scale-up. This qualitative study assessed the perceptions of HIVST among stakeholders in three sub-Saharan countries. Fifty-four key informant interviews were conducted in Kenya (n=6), Malawi (n=26) and South Africa (n=12) withh government policy makers, academics, activists, donors, procurement specialists, laboratory practitioners and health providers. A thematic analysis was conducted in each country and a common coding framework allowed for inter-country analysis to identify common and divergent themes across contexts. Respondents welcomed the idea of an accurate, easy-to-use, rapid HIV self-test which could increase testing across all populations. High-risk groups, such as men, Men who have sex with men (MSM), couples and young people in particular, could be targeted through a range of health facility and community-based distribution points. HIVST is already endorsed in Kenya, and political support for scale-up exists in South Africa and Malawi. However, several caveats remain. Further research, policy and ensuing guidelines should consider how to regulate, market and distribute HIVST, ensure quality assurance of tests and human rights, and critically, link testing to appropriate support and treatment services. Low literacy levels in some target groups would also need context-specific consideration before scale up. World Health Organization (WHO) policy and regulatory frameworks are needed to guide the process in those areas which are new or specific to self-testing. Stakeholders in three HIV endemic sub-Saharan countries felt that HIVST will be an important complement to existing community and facility-based testing approaches if accompanied by the same essential components of any HIV testing service, including access to accurate information and linkages to care. While there is an increasingly positive global policy environment regarding HIVST, several implementation and social challenges limit scale-up. There is a need for further research to provide contextual and operational evidence that addresses concerns and contributes to normative WHO guidance. en
dc.format.medium Print en
dc.subject KENYA en
dc.subject MALARIA en
dc.subject SELF-TESTING en
dc.subject HIV/AIDS en
dc.title What are the constraints and opportunities for HIVST scale-up in Africa?: evidence from Kenya, Malawi and South Africa en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber PMASAA en
dc.Volume 18 en
dc.BudgetYear 2014/15 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.SourceTitle Journal of the International AIDS Society en
dc.ArchiveNumber 8580 en
dc.URL http://ktree.hsrc.ac.za/doc_read_all.php?docid=15602 en
dc.PageNumber Online en
dc.outputnumber 7347 en
dc.bibliographictitle Van Rooyen, H., Tulloch, O., Mukoma, W., Makusha, T., Chepuka, L., Knight, L.C., Peck, R.B., Lim, J.M., Muturi, N., Chirwa, E. & Taegtmeyer, M. (2015) What are the constraints and opportunities for HIVST scale-up in Africa?: evidence from Kenya, Malawi and South Africa. <i>Journal of the International AIDS Society</i>. 18:Online. http://hdl.handle.net/20.500.11910/2009 en
dc.publicationyear 2015 en
dc.contributor.author1 Van Rooyen, H. en
dc.contributor.author2 Tulloch, O. en
dc.contributor.author3 Mukoma, W. en
dc.contributor.author4 Makusha, T. en
dc.contributor.author5 Chepuka, L. en
dc.contributor.author6 Knight, L.C. en
dc.contributor.author7 Peck, R.B. en
dc.contributor.author8 Lim, J.M. en
dc.contributor.author9 Muturi, N. en
dc.contributor.author10 Chirwa, E. en
dc.contributor.author11 Taegtmeyer, M. en

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