HIV Oral Self-testing (HiVST) Strategy for Increased HIV Testing Among Female Sex Workers (Fsw) in Nairobi County, Kenya

Abstract

This study aimed at determining the uptake of HIV Self-Test kits for HIV Testing among Female sex workers (FSW) in Starehe Sub-County, Nairobi County. The specific objectives included ascertaining the accessibility of HIV Self-Test (HIVST) kits, identifying the preferred method of distribution for uptake, effects of HIVST towards HIV test uptake among FSWs and determine the effect of HIV Self-Testing towards Linkage of HIV Positive FSW to treatment. The study was guided by three theories namely Rational Choice theory and Behavioral Theory. The study utilized a descriptive survey methodology to collect both qualitative and quantitative data where 80 FSW from 18 hot-spots typologies (14 venue-based hot-spots and 4 street-based hot-spots) within Starehe sub-county, Nairobi county were interviewed and 6 Key informant interviews with peer educators, Outreach workers and Health Care Workers conducted. Data was collected through smart android phones on a KOBO Toolkit and transmitted to a central database for analysis and Key Informant Interviews emerging themes were analyzed through Nvivo 9/12 software. The study noted higher acceptance of HIVST when offered to FSW at hot spots by Peer educators as compared to picking from healthcare facilities and Drop In Centers or buying from chemists and pharmacies. Affordability and proximity to health facilities were some of the major challenges that affected the uptake of the HIVST. Data showed that HIV self-testing has the potential to enhance overall HIV testing uptake, increase HIV testing frequency, reach sub-groups of high-risk FSWs, and has few potential downsides among FSWs. The study recommends affordable HIVST from chemists and Pharmacies within the localities of FSW due to the proximity of chemists and pharmacies to the hot spots. The study also recommends that governments need to consider partnerships with private entities to distribute HIVST to FSW. In addition, stakeholders including Public, Private institutions and CSOs need to develop policies and guidelines that enhance same-day linkage to treatment especially when HIVST is being delivered at the hot spots and not within health facilities where the treatment is. Peer educators who also issue HIVST need to be sensitized on linkage messages and mechanisms that encourage clients to visit a nearby health facility and also offer client-friendly psychosocial support.