Abstract:
Rapid oral HIV self-tests (HIVST) have potential to increase the proportion
of people who know their HIV status, especially among stigmatised
populations. This study was embedded in two cohorts of female sex
workers (FSW) in the Dominican Republic (DR) and Tanzania. Qualitative
interviews with 40 FSW were conducted to explore perceived
acceptability of HIVST. Interviews were analysed using inductive and
deductive thematic coding. Emergent themes were organised by socioecological
framework levels. FSW in both settings responded positively
to the ease of use of HIVST but questioned test accuracy due to the use
of saliva rather than blood. FSW in the DR had a more cautious
response, while women in Tanzania had favourable perceptions
expressing eagerness to use it. At the individual level, themes shaping
participants’ interest included autonomy, HIV risk perception, and
emotional well-being for those with reactive test results, and selfefficacy.
At the interpersonal level, privacy, confidentiality, sex work and
HIV stigma and social support were salient. Structural level themes
focused on health systems including linkages to HIV treatment, provider
roles, and access (cost, travel, distribution). Understanding FSW’s
perceptions and acceptability of HIVST is essential to its integration into
health systems and programmes using a community-driven approach.
