https://orcid.org/0000-0001-7329-7333
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ABSTRACT
Background
Emergency department-based HIV self-testing (ED-HIVST) could increase HIV-testing services to high-risk, under-reached populations.
Objectives
This study sought to understand the injury patient acceptability of ED-HIVST.
Methods
Injury patients presenting to the Kenyatta National Hospital Accident and Emergency Department were enrolled from March to May 2021. Likert item data on HIVST assessing domains of general acceptability, personal acceptability, and acceptability to distribute to social and/or sexual networks were collected. Ordinal regression was performed yielding adjusted odds ratios (aOR) to identify characteristics associated with high HIVST acceptability across domains.
Results
Of 600 participants, 88.7% were male, and the median age was 29. Half reported having primary care providers (PCPs) and 86.2% reported prior HIV testing. For each Likert item, an average of 63.5% of the participants reported they ‘Agree Completely’ with positive statements about ED-HIVST in general, for themselves, and for others. In adjusted analysis for general acceptability, those <25 (aOR = 1.67, 95%CI:1.36–2.08) and with prior HIV testing (aOR = 1.68, 95%CI:1.27–2.21) had greater odds of agreeing completely. For personal acceptability, those with a PCP (aOR = 3.31, 95%CI:2.72–4.03) and prior HIV testing (aOR = 1.83, 95%CI:1.41–2.38) had greater odds of agreeing completely. For distribution acceptability, participants with a PCP (aOR = 2.42, 95%CI:2.01–2.92) and prior HIV testing (aOR = 1.79, 95%CI: 1.38–2.33) had greater odds of agreeing completely.
Conclusions
ED-HIVST is perceived as highly acceptable, and young people with prior testing and PCPs had significantly greater favourability. These data provide a foundation for ED-HIVST programme development in Kenya.
Responsible Editor
Maria Emmelin
Responsible Editor
Maria Emmelin
Acknowledgements
The authors thank the personnel who assisted in the research and participants who took part in this study.
Author contributions
ARA, JK, RB, AM, KMG, TL, MM, DAK, CF, and MJM designed the study. ARA, JS, JK, RB, EO, BN, DKO, JAL, and AM executed the research activities. ARA, EO, BN, TL, MM, DAK, CF, and MJM were responsible for statistical analyses. SB and ARA drafted the manuscript, and all authors revised the manuscript and approved the final presentation.
Disclosure statement
No potential conflict of interest was reported by the authors.
Ethics and consent
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the KNH ethics and research committee (P29/01/2020) and the Rhode Island Hospital Institutional Review Board (1501033–3). Informed consent was obtained from all included participants. No identifying data or photographs are included in the article.
Paper context
HIV self-test programming from emergency departments represents an innovative approach to address challenges in HIV testing services for high-risk and poorly engaged populations in Africa. In the current analysis of 600 patient participants from Kenya the majority viewed emergency department-based HIV self-test access as favourable for self-use and for distribution to contacts. These data suggest that Kenyan emergency care patients are receptive to HIV self-testing access, and such programming may serve to increase testing.
Supplementary material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/16549716.2022.2157540.