Public Health Law Center.
Kenya Legal and Ethical Issues Network, Nairobi, Kenya.
Afr Health Sci. 2022 Jun;22(2):37-45. doi: 10.4314/ahs.v22i2.5.
BACKGROUND: Kenya's Key and Affected Populations (KAP) - men who have sex with men (MSM), female sex workers, people who inject drugs (PWID), and young women aged 18-24 - often experience stigma and discrimination in Kenyan health care settings due to their identity and/or behaviors, which can deter facility-based testing for HIV. Kenya has promoted self-testing as a means to reach these communities. OBJECTIVES: To identify KAP perspectives on self-testing and place our findings within Kenya's human rights and legal context. METHODS: We conducted 4 focus group discussions (FGD) and 16 in-depth interviews (IDI). One FGD was conducted with each of the following communities: MSM, female sex workers, PWID, and young women aged 18-24. 1-4 IDI were conducted with each KAP community, and 1-3 IDI were conducted with health professionals working on HIV care in each study site. The semi-structured question guideline included one question soliciting opinions on self-testing. RESULTS: KAP support self-testing in concept, however prevailing concerns among participants included access to pre- and post-test counseling services, as well as risk for harms (self-inflicted and otherwise) that might result from a positive result. CONCLUSION: Kenya should ensure that human rights are promoted and respected through implementing rights-based policies and practices for HIV self-testing, including pre- and post-test counseling.
背景:肯尼亚的关键和受影响人群(KAP)——男男性行为者(MSM)、性工作者、注射毒品者(PWID)以及 18-24 岁的年轻女性——由于其身份和/或行为,经常在肯尼亚的医疗保健环境中受到污名和歧视,这可能会阻止他们在医疗机构进行艾滋病毒检测。肯尼亚已经推广自我检测作为接触这些社区的一种手段。
目的:确定 KAP 对自我检测的看法,并将我们的发现置于肯尼亚的人权和法律背景下。
方法:我们进行了 4 次焦点小组讨论(FGD)和 16 次深入访谈(IDI)。每个 FGD 都是针对以下社区之一进行的:男男性行为者、性工作者、注射毒品者和 18-24 岁的年轻女性。每个 KAP 社区进行 1-4 次 IDI,每个研究地点的 HIV 护理工作的卫生专业人员进行 1-3 次 IDI。半结构化问题指南包括一个征求对自我检测意见的问题。
结果:KAP 在概念上支持自我检测,但参与者普遍关注的问题包括获得检测前和检测后咨询服务的机会,以及可能因阳性结果而导致的自我伤害和其他伤害的风险。
结论:肯尼亚应通过实施基于人权的艾滋病毒自我检测政策和做法,包括检测前和检测后咨询,确保促进和尊重人权。
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