Feasibility of an HIV self-testing intervention: a formative qualitative study among individuals, community leaders, and HIV testing experts in northern Tanzania
Outcomes: Human Immunodeficiency Virus
View SourceKey Social Norms Take-aways Supportive social norms—including beliefs that peers and family members would approve of HIV self-testing (HIVST)—may help drive uptake among high-risk populations in Tanzania. However, social norms were not central in participants’ discussions, suggesting that personal agency and privacy may be more decisive factors in self-testing behavior. Still, leveraging influential community leaders to advocate for HIVST could reinforce positive norms, reduce stigma, and increase community-level acceptability.
Objectives To explore attitudes, perceived social norms, and beliefs about personal agency related to HIV self-testing among female bar workers (FBWs), mountain climbing porters (MCPs), and key stakeholders in northern Tanzania, in order to inform the design of a future HIVST intervention.
Methods This qualitative formative study used the Integrated Behavior Model (IBM) to guide data collection and analysis. It involved 18 in-depth interviews with HIV experts, counselors, community leaders, and clinicians, as well as four focus group discussions with 37 FBWs and MCPs. Discussions were analyzed using the Framework Method to identify themes aligned with IBM constructs: attitudes, perceived norms, and personal agency.
Intervention Details The study is formative research for a future HIV self-testing intervention targeting FBWs and MCPs—two high-risk groups with limited access to conventional HIV testing services. Although no intervention was implemented, the study identifies key design and delivery considerations, including preferred distribution points (e.g., pharmacies, workplaces), preferred testing methods (oral-fluid kits), and barriers such as cost, stigma, and limited confidence in using kits independently.
Results Participants expressed overwhelmingly positive attitudes toward HIVST, citing privacy, convenience, reduced costs, and the avoidance of needles. Most believed their social networks would support HIVST. Many, especially men, felt confident in their ability to self-test, though women expressed more concerns about doing it correctly alone. Key barriers included affordability, lack of regulation and policies, illiteracy, fear of stigma, and concerns about linkage to care. Recommendations included training peer educators, involving community leaders in advocacy, and using digital tools to support follow-up and linkage.
Conclusions HIVST appears feasible and acceptable among FBWs and MCPs in northern Tanzania. Interventions should address cost barriers, ensure supportive follow-up mechanisms, and use community-based strategies to promote awareness and trust. While individual agency plays a major role, strengthening supportive norms through local influencers and education can enhance uptake and impact.
Disclaimer: These summaries were generated with the assistance of artificial intelligence and are based on the interpretation of source documents. While efforts have been made to ensure accuracy and clarity, there may be errors or omissions. Users are encouraged to consult the original documents for complete and authoritative information.