Adepoju Victor Abiola, Udah Donald Chinazor, Adnani Qorinah Estiningtyas Sakilah, Ahmed Mohamed Mustaf, Okesanya Olalekan John
Department of HIV and Infectious Diseases, Jhpiego (An Affiliate of Johns Hopkins University), Abuja, Nigeria.
Department of TB Data, Impact Assessment and Communications Hub (TB DIAH), John Snow Research & Training Institute, Inc., Abuja, Nigeria.
HIV AIDS (Auckl). 2024 Dec 11;16:467-476. doi: 10.2147/HIV.S501853. eCollection 2024.
BACKGROUND: HIV self-testing (HIVST) offers a novel solution for increasing HIV testing among pregnant and postpartum women and their male partners, especially in low-resource settings. These groups often face barriers such as stigma, fear, and limited access to traditional HIV-testing services. METHODS: We reviewed qualitative and quantitative studies focusing on HIVST implementation in both public and private healthcare settings among pregnant and postpartum women and male partners in sub-Saharan Africa (SSA), analyzed uptake, male involvement, and barriers. Articles from Scopus, PubMed, and Google Scholar were included to examine public and private settings, distribution models, and psychosocial support. RESULTS: HIVST showed substantial success in increasing the testing rates. For example, maternal retesting during pregnancy has increased by 35% in Kenya due to the adoption of HIVST. The secondary distribution also drove male partner testing, with 90.8% of male partners accepting HIVST kits from their pregnant partners in South Africa and 75.4% participating in couple testing. Combining HIVST with clinical invitations increased both female and male testing 12-fold in other studies. Despite these successes, challenges persisted, with approximately 30% of women testing HIV-positive not returning to follow-up care. In addition, a few women reported adverse partner reactions, including intimate partner violence (IPV), after delivering HIVST kits. CONCLUSION: HIVST presents a critical opportunity to close gaps in HIV prevention between pregnant women and their male partners. Addressing barriers, such as stigma and enhancing male partner involvement, provides a pathway for more equitable testing practices. Scaling up successful community-based and secondary distribution models, alongside addressing challenges such as follow-up care and IPV concerns, is essential for reducing HIV transmission in SSA.
J Acquir Immune Defic Syndr. 2024-3-1
BMC Health Serv Res. 2024-4-30
Ann Med Surg (Lond). 2023-11-1