Acceptability and strategies for enhancing uptake of human immunodeficiency virus self-testing in Nigeria

ARTICLE HIGHLIGHTS

Research background

Nigeria has a high burden of human immunodeficiency (HIV)/acquired immune deficiency syndrome, and a significant proportion of infected individuals remain untested due to fear of stigma and discrimination. HIV self-testing (HIVST) is recommended by the World Health Organization as a tool for improving testing uptake and achieving the United Nations Programme on HIV and acquired immune deficiency syndrome 90-90-90 target. However, HIVST is still a growing intervention in Nigeria, and there is a need to systematically review its acceptability and uptake in the country.

Research motivation

To systematically review the acceptability, existing regulations, and strategies for enhancing the uptake of HIVST in Nigeria.

Research objectives

To fill a crucial gap in understanding the HIVST landscape in Nigeria and provide insights into the evidence base on the acceptability and uptake of HIVST in the country.

Research methods

A systematic literature review was conducted, and 18 articles were included in the analysis.

Research results

The study found that the acceptability of HIVST is generally high in Nigeria from the intention-to-use perspective. However, the actual use of HIVST in programmatic implementation was lower than expected. The study recommends more controlled implementation studies to test the acceptability of HIVST and to explore factors responsible for poor uptake. The use of key opinion leaders among key populations has been found to be successful in increasing the acceptability and uptake of HIVST. However, cost remains a major barrier to the acceptability of HIVST among pharmacy retail outlets.

Research conclusions

The present study provided crucial understanding of the HIVST landscape in Nigeria, which is young and evolving. The study highlighted the need for further high-quality research in this area and recommended innovative financing approaches targeting different population segments for effective scaling of HIVST under the total market approach.

Research perspectives

More studies are required to evaluate how the uptake of HIVST compares in routine programs vs real-life settings in the absence of support and resources that enhance HIVST uptake. Overall, this study contributed to the current knowledge base on HIVST in Nigeria and highlighted the need for further high-quality research in this area.