Opinions towards Key Operational Aspects for the Implementation of HIV Self-Testing in Spain: A Comparison between Stakeholders and Potential Users
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Recruitment Procedures
2.3. Data Collection Instrument
2.4. Data Analysis
3. Results
3.1. Stakeholders’ General Characteristics
3.2. Knowledge and Opinions about Self-Testing
3.3. Willingness to Pay and HIV Self-Testing Potential Use
3.4. Reasons to Be Against and in Favor of Self-Testing
3.5. Preferred Settings to Obtain a Self-Test and Confirm a Reactive Result
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Public Health Professionals/Policy Makers (n = 33) | Clinical Providers (n = 290) | CBO/NGO Workers (n = 55) | p | ||||
---|---|---|---|---|---|---|---|
n | n | % | n | % | |||
Age | 0.006 | ||||||
<30 | 1 | 3.0 | 35 | 12.1 | 8 | 14.8 | |
30–39 | 3 | 9.1 | 52 | 17.9 | 16 | 29.6 | |
40–49 | 9 | 27.3 | 77 | 26.6 | 19 | 35.2 | |
≥50 | 20 | 60.6 | 126 | 43.4 | 11 | 20.4 | |
Education | <0.001 * | ||||||
3.0 | 1 | 0 | 0.0 | 15 | 27.8 | ||
University degree | 23 | 69.7 | 216 | 74.5 | 35 | 64.8 | |
Postgraduate | 9 | 27.3 | 74 | 25.5 | 4 | 7.4 | |
Job level | |||||||
High senior official | 2 | 6.5 | |||||
HIV and/or public health technician | 23 | 74.2 | |||||
Other | 6 | 19.4 | |||||
Clinical setting | |||||||
Primary care | 215 | 76.8 | |||||
HIV/STI specific settings | 37 | 13.2 | |||||
Secondary care setting (not HIV/STI specific) | 16 | 5.7 | |||||
Other | 12 | 4.3 | |||||
Profession | |||||||
Medical doctor | 224 | 80.3 | |||||
Nurse | 49 | 17.6 | |||||
Pharmacist | 2 | 0.7 | |||||
Other | 4 | 1.4 | |||||
Target population | |||||||
Mainly LGBT+ population | 17 | 32.7 | |||||
Mainly other key populations | 20 | 38.5 | |||||
Does not serve a specific group | 15 | 28.8 | |||||
Focus on HIV and/or other STIs | |||||||
Exclusively focused on HIV/STI | 22 | 44.0 | |||||
Although not exclusively it includes HIV/STIs | |||||||
The CBO has an HIV testing counselling service | 47 | 95.9 | |||||
Job directly involved with an HIV testing counselling service | 39 | 73.6 |
Knows about the Existence of HIV Self-Testing | In Favor of HIV Self-Testing | Would Pay 25–30 Euros for an HIV Self-Test | Would Have Used an HIV Self-Test if Already Available | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Stakeholders (n = 378) | % | PR | 95%CI | % | PR | 95%CI | % | PR | 95%CI | % | PR | 95%CI |
Public health professionals/policy makers (n = 33) | 67.7 | 4.7 | (3.6–6.0) | 55.2 | 0.6 | (0.5–0.9) | 37.5 | 0.8 | (0.5–1.2) | 80.6 | 1.1 | (0.9–1.3) |
Clinical providers (n = 290) | 32.2 | 2.2 | (1.8–2.7) | 67.5 | 0.8 | (0.7–0.9) | 29.4 | 0.6 | (0.5–0.7) | 73.3 | 1.0 | (0.9–1.1) |
CBO/NGO worker (n = 55) | 71.7 | 4.9 | (4.1–6.0) | 35.3 | 0.4 | (0.3–0.6) | 17.6 | 0.4 | (0.2–0.6) | 60.8 | 0.8 | (0.6–1.0) |
Potential users * (n = 3537) | 14.5 | ref. | 86.9 | ref. | 49.6 | ref. | 75.1 | ref. |
Stakeholders by Work Area (n = 378) | Potential Users * (n = 3537) | p | |||||||
---|---|---|---|---|---|---|---|---|---|
Public Health Professionals/Policymakers (n = 33) | Clinical Providers (n = 290) | CBO/NGO Workers (n = 55) | |||||||
n | % | n | % | n | % | n | % | ||
Users’ reasons to be against self-testing ** | 0.0066 | ||||||||
The presence of an expert to counsel and inform about the result is essential | 19 | 63.3 | 103 | 38.1 | 23 | 50.0 | 150 | 36.4 | |
Obtaining the sample, performing the test and interpreting the results should be done by a trained professional | 5 | 16.7 | 61 | 22.6 | 11 | 23.9 | 121 | 29.4 | |
Concerns about the validity of the results | 3 | 10.0 | 52 | 19.3 | 2 | 4.3 | 68 | 16.5 | |
Self-testing may help to maintain HIV as a matter of taboo/shame | 2 | 6.7 | 25 | 9.3 | 4 | 8.7 | 33 | 8.0 | |
People could be forced to self-test in front of their partner | 0 | 0.0 | 15 | 5.6 | 3 | 6.5 | 16 | 3.9 | |
Other | 1 | 3.3 | 14 | 5.2 | 3 | 6.5 | 24 | 5.8 | |
Users’ reasons to be in favor of self-testing ** | <0.0001 | ||||||||
It helps to keep their privacy | 12 | 41.4 | 90 | 33.5 | 16 | 32.7 | 782 | 24.8 | |
It helps to test whenever they can/want | 5 | 17.2 | 54 | 20.1 | 7 | 14.3 | 785 | 24.9 | |
It saves time, paperwork, queues, waiting time | 1 | 3.4 | 9 | 3.3 | 4 | 8.2 | 708 | 22.5 | |
It contributes to taking responsibility for their own health | 3 | 10.3 | 23 | 8.6 | 3 | 6.1 | 499 | 15.8 | |
It helps to avoid intimate and personal questions | 4 | 13.8 | 16 | 5.9 | 6 | 12.2 | 208 | 6.6 | |
It saves them judgmental attitudes (regarding sexual practices, sexual orientation…) | 2 | 6.9 | 71 | 26.4 | 11 | 22.4 | 89 | 2.8 | |
It allows one to avoid counselling | 0 | 0.0 | 2 | 0.7 | 1 | 2.0 | 10 | 0.3 | |
Other | 2 | 6.9 | 4 | 1.5 | 1 | 2.0 | 70 | 2.2 |
Type of Stakeholders (n = 378) | p | ||||||||
---|---|---|---|---|---|---|---|---|---|
Public Health Professionals/Policymakers (n = 33) | Clinical Providers (n = 290) | CBO/NGO Workers (n = 55) | Potential Users * (n = 3537) | ||||||
n | % | n | % | n | % | n | % | ||
Preferred setting to obtain a self-testing kit | <0.001 | ||||||||
Pharmacies | 11 | 36.7 | 94 | 37.0 | 12 | 26.7 | 701 | 38.3 | |
Through the internet | 8 | 26.7 | 49 | 19.3 | 10 | 22.2 | 438 | 23.9 | |
Supermarkets/drugstores | 2 | 6.7 | 35 | 13.8 | 5 | 11.1 | 378 | 20.7 | |
Vending machines | 1 | 3.3 | 21 | 8.3 | 2 | 4.4 | 195 | 10.7 | |
Community-based/non-governmental organizations | 7 | 23.3 | 44 | 17.3 | 15 | 33.3 | 78 | 4.3 | |
Purchasing it by phone | 1 | 3.3 | 5 | 2.0 | 0 | 0.0 | 13 | 0.7 | |
Other | 0 | 0.0 | 6 | 2.4 | 1 | 2.2 | 27 | 1.5 | |
Preferred setting for confirmation | <0.001 | ||||||||
HIV/STI testing service or clinic | 7 | 24.1 | 40 | 15.7 | 15 | 32.6 | 730 | 27.7 | |
General practitioner/family doctor | 8 | 27.6 | 141 | 55.3 | 1 | 2.2 | 586 | 22.2 | |
Hospital or clinic (including the emergency room) | 7 | 24.1 | 40 | 15.7 | 9 | 19.6 | 546 | 20.7 | |
Office of a medical specialist | 4 | 13.8 | 23 | 9.0 | 3 | 6.5 | 510 | 19.3 | |
Community-based/non-governmental organizations | 1 | 3.4 | 5 | 2.0 | 18 | 39.1 | 177 | 6.7 | |
Outreach activity (mobile unit, bar, club, or sauna) | 1 | 3.4 | 0 | 0.0 | 0 | 0.0 | 14 | 0.5 | |
Others ** | 1 | 3.4 | 6 | 2.4 | 0 | 0.0 | 73 | 2.8 |
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Hoyos, J.; Guerras, J.-M.; Maté, T.; Agustí, C.; Fernández-López, L.; Fuente, L.d.l.; Belza, M.-J. Opinions towards Key Operational Aspects for the Implementation of HIV Self-Testing in Spain: A Comparison between Stakeholders and Potential Users. Int. J. Environ. Res. Public Health 2021, 18, 1428. https://doi.org/10.3390/ijerph18041428
Hoyos J, Guerras J-M, Maté T, Agustí C, Fernández-López L, Fuente Ldl, Belza M-J. Opinions towards Key Operational Aspects for the Implementation of HIV Self-Testing in Spain: A Comparison between Stakeholders and Potential Users. International Journal of Environmental Research and Public Health. 2021; 18(4):1428. https://doi.org/10.3390/ijerph18041428
Chicago/Turabian StyleHoyos, Juan, Juan-Miguel Guerras, Tomás Maté, Cristina Agustí, Laura Fernández-López, Luis de la Fuente, and María-José Belza. 2021. "Opinions towards Key Operational Aspects for the Implementation of HIV Self-Testing in Spain: A Comparison between Stakeholders and Potential Users" International Journal of Environmental Research and Public Health 18, no. 4: 1428. https://doi.org/10.3390/ijerph18041428