A qualitative study on oral-fluid-based HIV self-testing experiences among men in Kigali, Rwanda

Introduction: there has been a global call to engage men in the fight against the HIV epidemic. Poor uptake of HIV testing services among men has been reported in most of sub-Saharan Africa where the HIV epidemic continues to be a major public health problem. HIV self-testing (HIVST) has potential to bridge the gap; however, there is a paucity of research evidence on oral-fluid-based HIVST experiences among men in Rwanda. The aim of this study was to assess oral-fluid-based HIVST experiences among men. Methods: a qualitative study based on individual interviews was employed on 21 men who voluntarily obtained oral-fluidbased HIV self-test kits and consented for followup post-test interviews. Interview guides explored men's perspectives on the oral fluid based HIV self-screening experience. A conventional content analysis qualitative approach was adopted, entailing inductive thematic analysis. Results: the majority of participants expressed satisfaction with the experience of self-testing, citing privacy and turn-around time. Participants presented contradicting views on usability of test kits and post-test status disclosure to sexual partners. One participant reported post-test distress resulting from unexpected results. Conclusion: HIVST is attractive to men and may have potential for improving uptake of HIV testing services in this group without compromising the testing experience. Concerns on missing linkage to care and potential social harms and adverse events should not be ignored.