Uptake andacceptability of oral HIV self testing in the context of assisted partner services in Western Kenya: A mixed-methods analysis

Abstract

e Abstract Integrating HIV self-testing (HIVST) into assisted partner services (APS) has potential to increase identification of people with HIV in the community, but little is known about accept ability of HIVST among partners traced via APS. We assessed characteristics of APS part ners testing with HIVST, and factors influencing HIVST uptake and acceptability in a cluster randomized control trial on APS+HIVST. Using convergent parallel mixed-methods design, weevaluated socio-demographic and behavioral characteristics of APS partners who were offered HIVST or provider-delivered testing, and purposively selected a sub-set of partners for in-depth interviews (IDIs). Descriptive and log-binomial regression analyses were per formed controlling for health facility clusters, while IDIs were thematically analyzed applying the theoretical framework of acceptability. Among 3312 partners who were offered HIVST or provider-administered testing through APS, 2724 (82.2%) used HIVST. There was no asso ciation between partner demographics and HIVST uptake. HIVST use was less likely than provider-delivered testing among those identified as a casual (adjusted relative risk (aRR) = 0.93; 95% Confidence Interval (CI) 0.88–0.98) or transactional (aRR = 0.90; 95% CI 0.87 0.94) partner compared to those in a defined relationship. HIVST use was slightly lower amongthoseoffered the option of an additional kit when compared to those only offered one kit (aRR = 0.93; 95% CI0.88–0.98). In the IDIs (N = 24), partners reported that HIVST was a viable option for individuals who do not find provider-delivered testing suitable or convenient. For the APSpartners, ‘intervention coherence’, ‘self-efficacy’, and ‘ethicality’ presented as most significant theoretical framework of acceptability constructs. APS providers played a critical role in creating HIVST awareness and driving acceptability. Increasing HIVST aware ness andproviding tailored solutions will empower APS clients optimize their HIV testing