Perspectives on HIV Self-Testing Among Key and Affected Populations in Kenya

Background: Kenya's Key and Affected Populations (KAP) - men who have sex with men (MSM), female sex workers, people who inject drugs (PWID), and young women aged 18-24 - often experience stigma and discrimination in Kenyan health care settings due to their identity and/or behaviors, which can deter facility-based testing for HIV. Kenya has promoted self-testing as a means to reach these communities. Objectives: To identify KAP perspectives on self-testing and place our findings within Kenya's human rights and legal context. Methods: We conducted 4 focus group discussions (FGD) and 16 in-depth interviews (IDI). One FGD was conducted with each of the following communities: MSM, female sex workers, PWID, and young women aged 18-24. 1-4 IDI were conducted with each KAP community, and 1-3 IDI were conducted with health professionals working on HIV care in each study site. The semi-structured question guideline included one question soliciting opinions on self-testing. Results: KAP support self-testing in concept, however prevailing concerns among participants included access to pre-and post-test counseling services, as well as risk for harms (self-inflicted and otherwise) that might result from a positive result. Conclusion: Kenya should ensure that human rights are promoted and respected through implementing rights-based policies and practices for HIV self-testing, including pre-and post-test counseling.