FEMALE SEX WORKERS PERCEPTION, CONCERN AND ACCEPTABILITY OF ORA QUICK HIV SELF TEST IN WOLDIA TOWN, NORTH WOLLO, ETHIOPIA, 2024.

ABSTRACT
Background: Ethiopia plans to achieve the United Nations AIDS (UNAIDS) 95-95-95 targets by 2025 and to end the HIV epidemic by 2030. To achieve these targets, HIVST is a crucial approach for individuals who do not know their status. In Ethiopia, there is a lack of evidence on the perception, acceptability, and concerns regarding OraQuick HIV self-testing. Therefore, we aimed to explore the perspectives, concerns, and acceptability of OraQuick HIV self-testing among female sex workers.
Objective: To explore female sex workers' perception, concern, and acceptability of Ora quick HIV self-test in Woldia town, North Wollo, Ethiopia, 2024.
Methods: The study used a phenomenological design and the Integrated Behavior Model as a theoretical framework from February 13 to 30, 2024, among 22 female sex workers and 10 key informants in Woldia town. Ten in-depth interviews, four key informant interviews, and three focused group discussions were conducted with individuals selected purposively until the point of saturation was reached. After the data were transcribed and translated, thematic analysis was done using Atlas.ti 7.5 software with the guidance of the Integrated Behavior Model framework.
Result: Most participants had a positive attitude towards testing with these devices and anticipated positive consequences, such as enhanced privacy, decreased waiting time, reduced transportation costs, increased accessibility for immobile individuals, elevated utility in index case screening and testing programs, and the provision of confidential, trustworthy, and reliable test results. Most female sex workers perceived that significant people in their social environment approved and used OraQuick HIVST. The facilitators to uptake of OraQuick HIVST among female sex workers included privacy, ease of use, and the lack of need for trained healthcare providers when testing Thus, most female sex workers were confident in their ability to test themselves and to interpret their test results using OraQuick HIVST.
To optimize uptake of testing using OraQuick, female sex workers proposed supplying kits in an easily accessible manner, increasing awareness about the kit, and advocating for and promoting the kits were strategies to facilitate HIVST uptake and maximize individuals’ self-efficacy. The perceived possible concerns or barriers to the uptake of OraQuick HIVST included a shortage of kits, doubts about reliability before education, absence of policies or guidelines for HIVST, lack of post-test counseling and immediate treatment for positive individuals, potential psychological trauma such as suicidal ideation or attempts, lack of linkage to care for those with reactive results, and inaccurate reporting of positive results or result concealment.
Conclusions: This finding suggests that OraQuick HIVST was acceptable by female sex workers in the study area, with the majority of female sex workers having a positive attitude, supportive social norms, and self-efficacy. Therefore, interventions to increase awareness, advocate for the kit, and address perceived concerns or barriers to HIVST are needed to maximize its uptake in the study setting.
Keywords: HIV, HIV self-test, OraQuick HIVST, qualitative study, Ethiopia.