Exploring HIV Self-Testing: Barriers and Facilitators Among Undergraduate Students in Nairobi, Kenya.

Abstract

Purpose: Infection with HIV remains a global health challenge, with >36.9 million individuals living with HIV in 2017. Despite efforts to increase HIV testing and treatment, traditional services have not effectively reached marginalized communities. The use of HIV self-testing (HIVST) offers a discreet and accessible alternative, potentially improving testing rates among at-risk populations including university students in Kenya.

Methods: We performed a cross-sectional analytical study using a multistage cluster sampling technique among undergraduate students at Kenyatta University. Clusters from various academic departments were randomly selected, and individual students were chosen for participation. Ethical approval was obtained from the Kenyatta University Ethics Review Committee and the National Commission for Science, Technology and Innovation. Participants were informed of the study's aims and their right to withdraw at any time. We collected data via questionnaires administered by trained enumerators.

Results: Participants' age averaged 21.1 years, with a majority being single, female, and full-time students. Substantial HIV knowledge was observed, and nearly one-half were aware of preexposure prophylaxis. Facility-based testing was prevalent, with significant preference for the OraQuick self-test kit among those who self-tested. Fear of positive results and stigma were primary barriers, whereas motivations for self-testing included routine use and protecting loved ones. Media exposure, especially the "Chukua Selfie" campaign, correlated with greater HIVST usage.

Conclusions: This study highlights the importance of school-based interventions and the critical role of academic institution support in HIV prevention. Participants' substantial knowledge of HIV contrasts with findings from other regions, underscoring the need for targeted education and safe-sex promotion. Addressing fear and stigma via comprehensive interventions is essential for improving HIVST uptake. Integrating HIVST into existing prevention programs can enhance HIV care frameworks in East Africa. Strategies to destigmatize HIV, ensure privacy in testing, and address misconceptions are vital for improving health outcomes among young individuals. Continuous efforts to strengthen self-testing programs are crucial to achieving global HIV targets.