Acceptance and associated factors of HIV self-test using oral fluid among targeted adult clients at public health facilities in Sheger City, Ethiopia, 2023.

Abstract

Background: Human immunodeficiency virus self-testing (HIVST) using oral fluid is the best way to receive preventive and treatment services, which helps lower morbidity and mortality related to the problem.

Purpose: To assess the acceptance and associated factors of human immunodeficiency virus self-testing using oral fluid among targeted adult clients at public health facilities in Sheger City, Ethiopia in 2023.

Patients and methods: An institution-based cross-sectional study was conducted from July 1 to 30, 2023 among clients visiting health facilities for Voluntary counseling and testing (VCT), Provider-initiated counseling and testing (PICT), and Prevention of mother-to-child transmission (PMTCT) services. A total of 317 study participants were selected using a systematic random sampling method. A structured questionnaire was used to collect data from the clients through interviews. Clients were asked to use HIVST using oral fluid when they came for HIV testing at the VCT, PICT, and PMTCT services, and those responded 'yes' to the question "will you accept HIVST using oral fluid today?", were considered as acceptors. Data were analyzed using bivariate and multivariable binary logistic regression. Variables with a p-value of < 0.25 in bivariate analysis, were candidates for multivariable analysis. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to identify the presence and strength of association.

Results: In total, 314 study participants were involved making a response rate of 99.1%. The overall acceptance of human immunodeficiency virus self-testing (HIVST) among targeted adult clients attending public health facilities in the study area was 169 (53.8%) (95%CI: 48.1%, 59.2%). Being married (AOR = 3.97; 95%CI: 1.74, 9.05), having fear of being stigmatized (AOR = 3.75; 95%CI: 1.64, 8.61), obtaining counseling during HIV testing (AOR = 3.33; 95%CI: 1.28, 8.64) and not sure about confidential information related to HIV testing (AOR = 2.49; 95%CI: 1.13, 5.46) were factors that were significantly associated with acceptance of HIVST using oral fluid.

Conclusion: This study found that acceptance of HIVST among targeted adults in public health facilities was consistent with global findings. Factors such as being married, fear of stigma, receiving counseling, and concerns about confidentiality were significantly associated with HIVST acceptance. Addressing these factors can help increase HIVST acceptance.