Acceptability Of Oral HIV Self-Testing Among Female Sex Workers In Accra, Ghana

Abstract

Background HIV testing is a key entry point to prevention and treatment measures. Key populations mostly have a lower uptake of HIV testing services because of several factors. In Ghana, HIV prevalence among Female Sex Workers is 4.67%, which is disproportionately higher in comparison to the national general population prevalence at 1.49%. This study investigated the acceptability of oral HIV Self-Testing (HIVST) among FSWs in Accra, Ghana. The study aimed to explore awareness of oral HIVST, perceived self-efficacy and perceived effectiveness of the oral HIVST. Methods A phenomenological qualitative design was employed to explore the acceptability of oral HIV self-testing (HIVST) among female sex workers (FSWs) in Accra, Ghana. Convenience sampling was used to recruit participants for 5 FGDs (n = 30) and 13 IDIs conducted in Ashaiman, East Legon, and Adabraka between May and September 2023. All interviews were audio-recorded and transcribed verbatim and analyzed thematically using NVivo 14. Results Findings generally showed a low level of awareness of oral HIVST. Despite this, several advantages were attributed to using oral HIVST, including confidentiality, convenience, and ease of use. The study further showed a preference for oral HIVST as compared to the standard HIV testing, as it is painless and does not involve blood. However, concerns arose about the accuracy of the test in diagnosing HIV, mostly because of the use of saliva as a sample specimen. Even though many participants (38/43, 88%) expressed confidence in performing the test, all of them could not correctly outline the procedure, and only 2/38 (5%) could correctly interpret the results. Conclusion Acceptability of oral HIV self-testing was high among FSWs, with many of them willing to use the oral HIVST, attributing it to the benefits of the test. The results suggest that the implementation of oral HIVST among FSWs can have a high uptake and help increase HIV testing coverage. There is a need for health education in the form of mass media campaigns, peer-led outreach campaigns and integration of the HIVST in routine services to improve awareness, testing techniques, and address individuals’ concerns about the test kit.