LoveYourself Inc, Mandaluyong City, NCR, Philippines.
Faculty of Management and Development Studies, University of the Philippines Open University, Laguna, Calabarzon, Philippines.
BMJ Open. 2022 Mar 21;12(3):e056697. doi: 10.1136/bmjopen-2021-056697.
Our study identified barriers and facilitators in implementing HIV self-testing (HIVST), including the perceptions of men-having-sex-with-men (MSM) and transgender women (TGW) on HIVST. Furthermore, we explored the current knowledge, practices and potential of HIVST among the MSM and TGW populations.
Qualitative in-depth key informant interviews were administered using semistructured interviews administered in both English and Filipino. Thematic analysis of the findings was done after transcribing all audio recordings.
The study was done in the National Capital Region (NCR), Philippines using online video conferencing platforms due to mobility restrictions and lockdowns caused by the COVID-19 pandemic.
All study participants were either MSM or TGW, 18-49 years old and residing/working in NCR. Exclusion criteria include biologically born female and/or currently on pre-exposure prophylaxis, antiretroviral therapy medications or an HIV-positive diagnosis.
Twenty informants were interviewed, of which 75% were MSM, and most of them preferred the use of HIVST. Facilitators and barriers to the use of HIVST were grouped into three main themes: Acceptability, distribution and monitoring and tracking. Convenience and confidentiality, overcoming fears and normalisation of HIV testing services (HTS) in the country were the participants' perceived facilitators of HIVST. In contrast, lack of privacy and maintenance of confidentiality during kit delivery were perceived as barriers in HIVST implementation. Moreover, social media was recognised as a powerful tool in promoting HIVST. The use of a welcoming tone and positive language should be taken into consideration due to the prevalent HIV stigma.
The identified facilitators and barriers from the study may be considered by the Philippine HTS programme implementers. The HIVST strategy may complement the current HTS. It will be very promising to involve the MSM and TGW communities and other key populations to know their HIV status by bringing testing closer to them.
本研究确定了实施 HIV 自我检测（HIVST）的障碍和促进因素，包括男男性行为者（MSM）和跨性别女性（TGW）对 HIVST 的看法。此外，我们探讨了 MSM 和 TGW 人群中 HIVST 的现有知识、实践和潜力。
采用英语和菲律宾语进行半结构式访谈，对关键知情人进行定性深入访谈。对所有音频记录进行转录后，对研究结果进行主题分析。
由于 COVID-19 大流行导致的流动性限制和封锁，本研究在菲律宾国家首都地区（NCR）使用在线视频会议平台进行。
所有研究参与者均为 18-49 岁、居住/工作在 NCR 的 MSM 或 TGW。排除标准包括生物学上的女性和/或正在服用暴露前预防、抗逆转录病毒治疗药物或 HIV 阳性诊断。
共访谈了 20 名受访者，其中 75%为 MSM，他们大多数人更喜欢使用 HIVST。HIVST 使用的促进因素和障碍分为三个主要主题：可接受性、分配和监测与跟踪。参与者认为 HIVST 的促进因素包括方便和保密性、克服恐惧以及该国 HIV 检测服务（HTS）的正常化。相比之下，在试剂盒交付过程中缺乏隐私和保密性被认为是 HIVST 实施的障碍。此外，社交媒体被认为是推广 HIVST 的有力工具。由于普遍存在的 HIV 耻辱感，应考虑使用欢迎的语气和积极的语言。
研究中确定的促进因素和障碍可被菲律宾 HTS 方案实施者考虑。HIVST 策略可能会补充当前的 HTS。通过将检测更接近他们，让 MSM 和 TGW 社区以及其他关键人群了解自己的 HIV 状况，将非常有希望。
