Uptake of HIV self testing among most at risk populations taking HIV pre-exposure prophylaxis in central Uganda:

Abstract

In Uganda, about 78% of the people living with HIV know their status compared to the global target of 90% by 2020. HIV self-testing (HIVST) could be a suitable strategy in identifying people living with HIV who do not regularly seek for HIV testing services. This study assessed the uptake of HIV self-testing among Most at Risk Populations (MARPS) currently enrolled on HIV Pre-Exposure Prophylaxis in Uganda. Methods: This was a mixed methods cross-sectional study involving 366 MARPs attending Pre-Exposure clinics at MARPI clinic Mulago Kampala and Kasensero HC II Kyotera clinic. Data collection tools were an interviewer administered structured questionnaire and an in depth interviews guide. A chi square test was performed to determine association between socio demographic, economic factors and propensity to uptake HIVST while logistic regression was used to determine the predictors of uptake of HIVST. Deductive thematic content analysis was performed to explore factors that promote and inhibit HIVST uptake. Results: There was 100% (365/365) acceptability for HIV self-testing and 66% (n=243) of respondents had high propensity to uptake HIVST. Predictors of uptake were location of clinic (rural vs urban) (aOR = 17.63 95% CI 8.44 – 36.81, p<0.001); key population category (female sex worker’s vs others) aOR= 4.36 (95% CI: 1.63 – 11.66, p=0.003) and education level (<primary vs post primary) aOR=0.38 (95% CI: 0.20 – 0.73). Conclusions: HIV self-testing is highly acceptable among clients taking PreP in central Uganda. Uptake of HIVST is significantly associated with the location of the PreP clinic, the MARP category and one’s level of education. HIVST kit distribution can employ a multi model approach. Recommendation: HIVST should be adopted as an HIV testing approach in clients taking PreP.