1. UNITAID PSI HIV SELF-TESTING AFRICA
Feasibility of HIV self-test programming among female sex workers in Zimbabwe
Sue Napierala Mavedzenge, RTI International
UNITAID PSI HIV SELF-TESTING AFRICA

2. Background FSW are disproportionately affected by HIV
Engagement in HIV services does not reflect heightened risk
Increasing HIV testing is the first step towards prevention and care services
Cowen, F.M. et al., 2017

3. Background
Little research on HIVST among FSW, which may be particularly appropriate for this population
Supervised self-testing among 40 FSW using instructions validated among a general population demonstrated excellent accuracy
Napierala Mavedzenge et al., unpublished data

4. Methodology
We offered HIVST for 6 months at a dedicated FSW clinic in Zimbabwe
FSW presenting for testing were given the option of provider delivered testing or HIVST
Participants received self-test kits and validated instructions
They were contacted after 2 weeks
to complete a questionnaire about
their experience

5. Results: HIVST uptake and use
607 FSW presented for testing and 325 (54%) opted for HIVST (p=0.10)
100% used the self-test
313 (96%) tested at the clinic site
4 (1%) tested with someone else present
100% reported the self-test was not at all hard to use

6. Baseline characteristics of those opting to self-test (N=325)

7. HIVST results and linkage

8. Acceptability of HIVST among FSW

9. Willingness of FSW to pay for HIV self-test (n=325)

10. Qualitative Results FSW concerns about making HIVST available
38% thought forced testing was possible
FSW thought HIVST promotion should be via mass media; pamphlets/posters at beerhalls & clinics; PE & outreach
FSW thought HIVST distribution should be via clinic (62%), pharmacy (18%), peer (14%) and/or workplace (13%).

11. Next steps
HIVST distribution now at 6 dedicated FSW clinics, and 12 outreach sites
Preparing to begin community distribution
FSW may take additional test kits for partners
FGD among FSW indicate that we are still not reaching those who do not attend clinic services (WEPDD0102)

12. Conclusions
FSW found HIVST highly acceptable, wanted HIVST to be available, expressed willingness to pay for kits
A high proportion of FSW had reactive self-test; virtually all linked to posttest services by 2 week follow-up
Some concern expressed around HIVST scale-up, along with suggestions for mediation
FSW provided useful insight into how to distribute and promote HIVST
HIVST represents a promising strategy to promote regular retesting among FSW in Zimbabwe

13. Acknowledgements Thank you! FSW in Zimbabwe for their participation
Co-authors
Frances Cowan
Euphemia Sibanda
Karin Hatzold
Jeffrey Dirawo
Owen Mugurungi
For their generous financial support
RTI International
DfID
UNITAID
Thank you!