Matovu Joseph K B, Kisa Rose, Buregyeya Esther, Chemusto Harriet, Mugerwa Shaban, Musoke William, Vrana Caroline J, Malek Angela M, Korte Jeffrey E, Wanyenze Rhoda K
a Department of Disease Control and Environmental Health , Makerere University School of Public Health , Kampala , Uganda.
b Directorate of Research and Strategic Information , Mildmay Uganda , Kampala , Uganda.
Glob Health Action. 2018;11(1):1503784. doi: 10.1080/16549716.2018.1503784.
BACKGROUND: HIV self-testing (HIVST) can improve HIV-testing rates in 'hard-to-reach' populations, including men. We explored HIVST perceptions, delivery strategies, and post-test experiences among pregnant women and their male partners in Central Uganda. METHODS: This was a qualitative study implemented as part of a pilot, cluster-randomized oral HIVST intervention trial among 1,514 pregnant women attending antenatal care services at three health facilities in Central Uganda. The qualitative component of the study was conducted between February and March 2017. We conducted 32 in-depth interviews to document women and men's perceptions about HIVST, strategies used by women in delivering the kits to their male partners, male partners' reactions to receiving kits from their female partners, and positive and negative social outcomes post-test. All interviews were audio-recorded, transcribed verbatim, and analyzed manually following a thematic framework approach. RESULTS: Women were initially anxious about their male partners' reaction if they brought HIVST kits home, but the majority eventually managed to deliver the kits to them successfully. Women who had some level of apprehension used a variety of strategies to deliver the kits including placing the kits in locations that would arouse male partners' inquisitiveness or waited for 'opportune' moments when their husbands were likely to be more receptive. A few (three) women lied about the purpose of the test kit (testing for syphilis and other illnesses) while one woman stealthily took a mucosal swab from the husband. Most men initially doubted the ability of oral HIVST kits to test for HIV, but this did not stop them from using them. Both men and women perceived HIVST as an opportunity to learn about each other's HIV status. No serious adverse events were reported post-test. CONCLUSION: Our findings lend further credence to previous findings regarding the feasibility of female-delivered HIVST to improve male partner HIV testing in sub-Saharan Africa. However, support for women in challenging relationships is required to minimize potential for deception and coercion.
背景：艾滋病毒自我检测（HIVST）可以提高包括男性在内的“难以接触到”人群的艾滋病毒检测率。我们在乌干达中部地区探讨了孕妇及其男性伴侣对HIVST的认知、检测包发放策略以及检测后的体验。 方法：这是一项定性研究，作为一项试点、整群随机口服HIVST干预试验的一部分，该试验在乌干达中部三个卫生机构接受产前护理服务的1514名孕妇中进行。研究的定性部分于2017年2月至3月开展。我们进行了32次深入访谈，以记录女性和男性对HIVST的认知、女性向男性伴侣发放检测包所采用的策略、男性伴侣收到女性伴侣发放的检测包后的反应，以及检测后的积极和消极社会结果。所有访谈均进行了录音，逐字转录，并按照主题框架方法进行人工分析。 结果：女性最初担心如果把HIVST检测包带回家，男性伴侣会有何反应，但大多数女性最终成功地将检测包交给了他们。有一定担忧的女性采用了多种策略来发放检测包，包括将检测包放在能引起男性伴侣好奇心的地方，或者等待丈夫可能更容易接受的“合适”时机。少数（三名）女性对检测包的用途进行了谎报（检测梅毒和其他疾病），而一名女性偷偷从丈夫那里采集了黏膜拭子。大多数男性最初怀疑口服HIVST检测包检测艾滋病毒的能力，但这并没有阻止他们使用检测包。男性和女性都将HIVST视为了解彼此艾滋病毒感染状况的一个机会。检测后未报告严重不良事件。 结论：我们的研究结果进一步证实了先前关于在撒哈拉以南非洲由女性发放HIVST以提高男性伴侣艾滋病毒检测可行性的研究结果。然而，需要为处于具有挑战性关系中的女性提供支持，以尽量减少欺骗和强迫的可能性。
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