Acceptability of HIV self-sampling kits (TINY vial) among people of black African ethnicity in the UK: a qualitative study

C Dodds, E Mugweni, G Phillips, C Park, I Young, I Fakoya, S Wayal, L McDaid, M Sachikonye, J Chwaula, P Flowers, F Burns, C Dodds, E Mugweni, G Phillips, C Park, I Young, I Fakoya, S Wayal, L McDaid, M Sachikonye, J Chwaula, P Flowers, F Burns

Abstract

Background: Increasing routine HIV testing among key populations is a public health imperative, so improving access to acceptable testing options for those in need is a priority. Despite increasing targeted distribution and uptake of HIV self-sampling kits (SSKs) among men who have sex with men in the UK, little is known about why targeted SSK interventions for black African users are not as wide-spread or well-used. This paper addresses this key gap, offering insight into why some groups may be less likely than others to adopt certain types of SSK interventions in particular contexts. These data were collected during the development phase of a larger study to explore the feasibility and acceptability of targeted distribution of SSKs to black African people.

Methods: We undertook 6 focus groups with members of the public who self-identified as black African (n = 48), 6 groups with specialists providing HIV and social services to black African people (n = 53), and interviews with HIV specialist consultants and policy-makers (n = 9). Framework analysis was undertaken, using inductive and deductive analysis to develop and check themes.

Results: We found three valuable components of targeted SSK interventions for this population: the use of settings and technologies that increase choice and autonomy; targeted offers of HIV testing that preserve privacy and do not exacerbate HIV stigma; and ensuring that the specific kit being used (in this case, the TINY vial) is perceived as simple and reliable.

Conclusions: This unique and rigorous research offers insights into participants' views on SSK interventions, offering key considerations when targeting this population.. Given the plethora of HIV testing options, our work demonstrates that those commissioning and delivering SSK interventions will need to clarify (for users and providers) how each kit type and intervention design adds value. Most significantly, these findings demonstrate that without a strong locus of control over their own circumstances and personal information, black African people are less likely to feel that they can pursue an HIV test that is safe and secure. Thus, where profound social inequalities persist, so will inequalities in HIV testing uptake - by any means.

Keywords: African; Ethnicity; Feasibility; HIV; Qualitative; Self-sampling; Testing; United Kingdom.

Conflict of interest statement

Ethics approval and consent to participate

This research was undertaken in accordance with the Declaration of Helsinki and was approved by the University College London Ethics Committee (Project ID 3321/001). All participants read a study information sheet gave signed consent to participate in this research.

Consent for publication

As a part of the consenting process, all participants were asked for consent to use non-attributable quotes in publications. Other than this, no individual data, images or videos of participants have been published.

Competing interests

The authors declare they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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