Methodological Considerations for Analysing Linkage to Care Determinants after HIV Self-Testing among University Students in Ibadan, Nigeria

HIV self-testing (HIVST) is a key strategy to increase diagnosis among young people in high-prevalence settings. A critical gap remains in ensuring those with a positive result link to formal healthcare for confirmatory testing and treatment. University students in Ibadan, Nigeria, represent a priority population for understanding the facilitators and barriers to this linkage. This methodology article details a culturally adapted mixed-methods approach for analysing determinants of linkage to care after a positive HIVST result among university students in Ibadan. The objective is to provide a replicable framework for similar studies in comparable settings. The design is an explanatory sequential mixed-methods study. A quantitative cross-sectional survey will be administered to a stratified random sample of students with a positive HIVST result, measuring linkage outcomes and potential determinants. Subsequently, in-depth interviews and focus group discussions will be conducted with a purposively selected sub-sample to explore quantitative findings. Key considerations include ethical procedures for tracing, ensuring confidentiality, and using Andersen's Behavioural Model of Health Services Use as the theoretical framework. As a methodology article, this paper presents no empirical results. It details the proposed study design and analytical approach. The qualitative phase is anticipated to explore themes related to stigma and privacy concerns as potential primary barriers to linkage. The outlined methodology provides a contextually appropriate approach for investigating a complex public health behaviour. It balances quantitative measurement of determinants with qualitative exploration of underlying reasons, which is crucial for developing effective interventions. Researchers investigating post-HIVST linkage in similar populations should prioritise ethical recruitment, integrate a theoretical framework, and employ mixed methods to capture the multifaceted nature of care-seeking behaviour. Programme planners should use findings from such studies to design tailored support services. HIV self-testing, linkage to care, methodology, mixed methods, university students, Nigeria. This article provides a detailed methodological framework for investigating determinants of post-HIVST linkage to care, aiming to strengthen the rigour and comparability of future research in similar African youth populations.