Society for Family Health, Abuja, Nigeria.
Population Services International, Nairobi, Kenya.
PLoS One. 2023 Apr 27;18(4):e0285003. doi: 10.1371/journal.pone.0285003. eCollection 2023.
BACKGROUND: HIV is a public health burden in Nigeria. HIV self-testing is one of the approaches to testing, which is the first of the 95:95:95 cascade of a coherent response to the epidemic. The ability to self-test HIV is influenced by various factors that can either serve as enablers or barriers. Exploring these enablers and barriers to the uptake of HIVST will help achieve optimal HIV self-testing and provide a deeper understanding of the HIVST kits users' journey. OBJECTIVE: The purpose of the study was to identify enablers and barriers to the uptake of HIV self-testing among sexually active youth in Nigeria using journey map methodology. METHODS: We conducted a qualitative exploratory study between January 2021 to October 2021 to understand the journey map for taking up and using HIVST in the private health delivery systems which include the pharmacies and PPMVs. 80 youths in Lagos, Anambra and Kano states were interviewed using IDIs and in-person FGDs. Their responses were audio-recorded, transcribed and analyzed using a qualitative software package (Nvivo software). RESULTS: A journey map for taking up and effectively using HIVST using the private sector among sexually active youths using key enablers and barriers at the attract, purchase, use, confirmation, linkage, and reporting stage was developed. The major enablers among participants were privacy and confidentiality, bundling purchases with other health products, easy-to-use instructions, and past experience with other self-testing kits. The major barriers were fear of discrimination, big packaging, high price, lack of confidence from user error and fear of status disclosure. CONCLUSIONS: Sexually active young people's perspectives enhance our understanding of the barriers and enablers of using HIVST through the private sector. Optimizing the enablers such as improved confidentiality that may be seen in e-pharmacy, reducing barriers and factoring sexually young people's perspectives will enhance the market and the uptake of HIVST towards ensuring sustainability and accelerating progress towards the 95-95-95 targets.
背景：艾滋病病毒在尼日利亚是一个公共卫生负担。艾滋病病毒自我检测是检测方法之一，是对疫情采取协调一致应对措施的 95-95-95 级联中的第一步。进行艾滋病病毒自我检测的能力受到各种因素的影响，这些因素既可以成为促进因素，也可以成为障碍。探讨接受艾滋病病毒自我检测的促进因素和障碍因素，有助于实现最佳的艾滋病病毒自我检测，并深入了解艾滋病病毒自我检测工具使用者的体验。 目的：本研究旨在使用行程图方法确定尼日利亚性活跃青年接受艾滋病病毒自我检测的促进因素和障碍因素。 方法：我们于 2021 年 1 月至 2021 年 10 月开展了一项定性探索性研究，以了解在私人医疗服务系统（包括药店和私人医疗服务供应商）中接受和使用艾滋病病毒自我检测的行程图，包括性活跃的青年。在拉各斯、阿南布拉和卡诺州，对 80 名青年进行了个人深入访谈和个人焦点小组讨论。他们的回答被录音、转录，并使用定性软件包（Nvivo 软件）进行分析。 结果：制定了一个使用私营部门进行性活跃青年接受和有效使用艾滋病病毒自我检测的行程图，其中包括在吸引、购买、使用、确认、联系和报告阶段的主要促进因素和障碍因素。参与者的主要促进因素包括隐私和保密性、将购买与其他健康产品捆绑、易于使用的说明以及过去使用其他自我检测工具包的经验。主要障碍包括歧视恐惧、大包装、高价格、因用户错误而缺乏信心以及对身份披露的恐惧。 结论：性活跃青年的观点增强了我们对通过私营部门使用艾滋病病毒自我检测的障碍和促进因素的理解。优化促进因素，如在电子药房中看到的更好的保密性，减少障碍，并考虑到性活跃青年的观点，将增强市场对艾滋病病毒自我检测的接受度，并加快实现 95-95-95 目标的进展。
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