Impact Research and Development Organization, Kisumu, Kenya.
U.S. Centers for Disease Control and Prevention, Division of Global HIV and TB, Atlanta, GA, USA.
AIDS Care. 2022 Jun;34(6):717-724. doi: 10.1080/09540121.2021.1894318. Epub 2021 Mar 3.
In Kenya, HIV prevalence estimates among female sex workers (FSWs) are almost five times higher than among women in the general population. However, only 68% of infected FSWs are aware of their HIV-positive status. We aimed to identify perceived benefits, opportunities, and barriers of HIV self-testing (HIVST) in improving testing coverage among FSWs. Twenty focus group discussions were conducted with 77 service providers, 42 peer educators (PEs) and outreach workers, and 37 FSWs attending drop-in centers (DiCEs) in four regions of Kenya. An additional 8 FSWs with HIV-negative or unknown status-completed in-depth interviews. Data were analyzed thematically. Acceptability of HIVST was high, with cited benefits including confidentiality, convenience, and ease of use. Barriers included absence of counseling, potential for inaccurate results, fear of partner reaction, possible misuse, and fear that HIVST could lead to further stigmatization. PEs and DiCEs were the preferred models for distributing HIVST kits. FSWs wanted kits made available free or at a nominal cost (100 Kenya Shillings or ∼USD 1). Linkage to confirmatory testing, the efficiency of distributing HIVST kits using peers and DiCEs, and the types and content of effective HIVST messaging require further research.
在肯尼亚，性工作者（FSWs）中的艾滋病毒流行率估计几乎是普通人群中女性的五倍。然而，只有 68%的感染 FSWs 意识到自己的艾滋病毒阳性状况。我们旨在确定 HIV 自我检测（HIVST）在提高 FSWs 检测覆盖率方面的感知益处、机会和障碍。在肯尼亚的四个地区，与 77 名服务提供者、42 名同伴教育者（PEs）和外展工作者以及 37 名参加随时咨询中心（DiCE）的 FSWs 进行了 20 次焦点小组讨论。另外 8 名 HIV 阴性或未知状态的 FSWs 完成了深入访谈。数据进行了主题分析。HIVST 的可接受性很高，其益处包括保密性、便利性和易用性。障碍包括缺乏咨询、潜在的不准确结果、担心伴侣的反应、可能的滥用、以及担心 HIVST 可能会导致进一步的污名化。PEs 和 DiCEs 是分发 HIVST 试剂盒的首选模式。FSWs 希望免费或象征性收费（100 肯尼亚先令或 ∼1 美元）获得试剂盒。与确认性检测的联系、使用同伴和 DiCEs 分发 HIVST 试剂盒的效率，以及有效的 HIVST 信息传递的类型和内容，都需要进一步研究。
