Acceptability of HIV Oral Self-test Among Truck Drivers and Youths: A Qualitative Investigation From Pune, Maharashtra

INTRODUCTIONEnding AIDS by 2030 is a global target, to which India is a signatory. HIV self-test (HIVST) coupled with counselling and AIDS-care, including antiretroviral therapy, has the potential to achieve this. However, countries are at varying stages of acceptance of HIVST as discussions around introducing it in national program sparks controversy and debates. HIV self-test, as yet, is not part of the AIDS control program in India. Against this backdrop, we explored acceptability of an HIV oral self-test (HIVOST) among truckers and young men and women.METHODSA qualitative investigation with 41 in-depth-interviews and 15 group discussions was conducted among study participants in the district of Pune, in the western state of Maharashtra, India. These interactions were built around a prototype HIVOST kit, which was placed before the study participants to help taking the discussions forward. The software N-vivo (version 11.0) was used to manage the volumes of data generated through the aforementioned process. The study period spanned from June through December, 2019.RESULTSWhile the truckers belonged to the age bracket 21-67 year, the youths were in the age group 18-24 year. ‘Ease of doing HIVOST' and ‘fear of needle pricks’ were the reasons for expressing acceptance around HIVOST by both the study groups. Truckers felt that HIVOST would encourage one to know one’s HIV status and seek help as appropriate. Accuracy of HIVOST result and disposal of the kits following use were concerns of a few. Most of the participants preferred saliva over blood as the specimen of choice. Instructions in local language reportedly would enable test-use by self. The truck drivers preferred undertaking HIVOST at the truckers-friendly 'Khushi clinics’ or in the vehicle, while youths preferred the privacy of home. Some of the young men mis-perceived the utility of HIVOST by referring to doing a test on a partner immediately prior to sexual encounter. Some of the truckers had myths and misconceptions about routes of HIV transmission and treatment. CONCLUSIONSOverall, the study communities expressed their acceptance towards HIVST approach. The National AIDS Control Program, India could draw upon the findings of the current study.