Prevalence, associated factors, barriers and facilitators for Oral HIV Self-Testing among Partners of Pregnant Women Attending Antenatal Care Clinics in Wakiso District, Uganda

Abstract

Background: Oral HIV self-testing (HIVST) among men is relatively low and still inadequate in Sub-Saharan Africa. Delivering HIVST kits by pregnant women attending antenatal care to their male partners is a promising strategy for increasing HIV testing among men. However, even amidst the interventions, most men still do not know their HIV status. This study, therefore, aimed to determine the proportion of male partners who received and used oral HIVST kits from their pregnant women, associated factors, barriers, and facilitators of oral HIVST among partners.

Methods: The study used an exploratory sequential mixed methods study design. 380 participants were recruited to determine the prevalence, and factors associated with oral HIV self-testing. Lists of male partners in the log books whose women picked an HIVST kit were obtained and systematic random sampling was done to obtain names of participants. 14 male partners were selected for in-depth interviews (IDIs) to identify barriers and facilitators. A modified poison regression was used to determine the proportion association of Oral HIVST using STATA version 14 analysis software. IDIs were conducted with purposively selected partners of Pregnant women to identify the barriers and facilitators for Oral HIVST. Audio-recorded data were transcribed and analysed using Dedoose.

Results: Out of 380 male participants recruited into the study, 260 (68.4%) received an oral HIVST kit from their pregnant women. The proportion of male partners who used the received Oral HIVST kit was 215 (82.7%). Variables associated with oral HIVST were; Information Education and Communication CPR 1.64 [1.48-1.82], place of testing CPR 1.04 [1.01-1.08], and being aware of the woman’s HIV status CPR 1.04 [0.99-1.09]. The barriers for oral HIVST were; lack of trust in the HIVST kit results, fear of test outcome in the presence of the partner, and the inclination that the HIV status of their women is the same as theirs. Facilitators included convenience, ease of use, prior awareness of their HIV status, and fear of relationship consequences and breakup.

Conclusion: Delivery of oral HIVST kits through pregnant women reached a high proportion of men. Based on the findings, 260 men received an Oral HIVST kit; of these, 82.7% used the kit. This was positively associated with Information Education and Communication, place of HIV testing, and awareness of their woman’s HIV status. Barriers were a lack of trust in the HIV self-testing kit and an inclination that the HIV status of their partners is the same as theirs; facilitators were convenience and fear of relationship consequences.