Acceptability of HIV Oral Self-Test Among Truck Drivers and Youths - A Qualitativ
Acceptability of HIV Oral Self-Test Among Truck Drivers and Youths - A Qualitativ
Acceptability of HIV Oral Self-Test Among Truck Drivers and Youths - A Qualitativ
PMCID: PMC8543938
Published online 2021 Oct 24. doi: 10.1186/s12889-021-11963-7 PMID: 34689729
Acceptability of HIV oral self-test among truck drivers and youths: a qualitative
investigation from Pune, Maharashtra
Amrita Rao,#1 Sandip Patil,#1 Pranali Pramod Kulkarni,2 Aheibam Sharmila Devi,2
Suryakant Shahu Borade,2 Dhammasagar D. Ujagare,2 Rajatashuvra Adhikary,3 and Samiran Panda
1,4
Abstract
Background
Ending AIDS by 2030 is a global target, to which India is a signatory. HIV-self-test (HIVST)
coupled with counselling and AIDS-care, including antiretroviral therapy, has the potential to
achieve this. However, national programs are at varying stages of acceptance of HIVST, as
discussions around its introduction spark controversy and debates. HIV-self-test, as yet, is not
part of the AIDS control program in India. Against this backdrop, we explored acceptability
of an HIV oral self-test (HIVOST) among truckers and young men and women.
Methods
Results
While the truckers belonged to the age bracket 21–67 year, the youths were in the age group
18–24 year. ‘Ease of doing HIVOST’ and ‘fear of needle pricks’ were the reasons behind
acceptance around HIVOST by both the study groups. Truckers felt that HIVOST would
encourage one to know one’s HIV status and seek help as appropriate. Accuracy of HIVOST
result and disposal of the kits following use were concerns of a few. Most of the participants
preferred saliva over blood as the specimen of choice. Instructions in local language
reportedly would enable test-use by self. The truck drivers preferred undertaking HIVOST at
the truckers-friendly ‘Khushi clinics’ or in the vehicle, while youths preferred the privacy of
home. Some of the young men mis-perceived the utility of HIVOST by referring to doing a
test on a partner immediately prior to sexual encounter. On the other hand, a few truckers had
wrong information on HIV cure.
Conclusions
Overall, the study communities expressed their acceptance towards HIV-self-test. The
National AIDS Control Program, India would benefit by drawing upon the findings of the
current investigation. Existing myths and misconceptions around HIV test and treatment
require program attention.
Supplementary Information
Background
In India the HIV epidemic is on a decline. However, there are still pockets, where HIV is
concentrated among the key population groups namely female sex workers (FSW; 1.56%),
people who inject drugs (PWID; 6.26%), men having sex with men (MSM;2.69%) and
transgender community (TG; 3.14%) [1]. This was the case even in the early days of the
epidemic barring six states (Andhra Pradesh, Tamil Nadu, Maharashtra, Karnataka, Manipur
and Nagaland), where a generalized epidemic was witnessed [2]. More than 1% antenatal
clinic (ANC) clinic attending women, were detected with HIV in these states indicating
wider spread of the virus beyond most at risk population (MARP) groups [3]. Based on such
observations, the targeted intervention (TI) programs were designed, in the long run such an
approach has been evaluated to be cost effective [4]. Overall goal of these TI programs in
various states was to reduce the vulnerability of the above cited population groups to HIV
and other sexually transmitted infections (STIs) and to establish a linkage with HIV care.
The risk of bridge populations such as long distant truckers, migrant workers and other
clients of sex workers to HIV was also recognized during the early phase of the AIDS control
program in India and interventions were designed to address them as well. The relevance of
this approach was underlined by the epidemiologic link, which was established behind the
spread of HIV from MARP groups to general population through bridge groups [5].
However, HIV intervention focus, currently directed towards bridge population is not as
intense as it used to be earlier. Decreasing HIV prevalence in India in the recent past during
2005 to 2010 might be contributing to such reduced attention [6]. What is of concern though,
that the HIV prevalence is refusing to go further down since 2010 [7]. Worth noting against
this background is that approximately 69,000 new HIV infections took place in India in 2019
[8]. What is known is that the HIV prevalence among truck drivers is at 0.86% which is
about 3 times higher than the national average adult HIV prevalence [9]. However, age
specific HIV prevalence data pertaining to young adults in India is sparse. Considered
together, these information not only underline that the residual risks of HIV that exist in the
country, but also the need for urgent intervention development. Failing to do so, will
negatively impact upon the targets of 95:95:95 to be achieved by 2030. Such targets require
95% of the people living with HIV knowing their status, of whom at least 95% will be put on
anti-retroviral therapy (ART) and 95% of those on ART would achieve undetectable HIV
viral load [10].
Vulnerability of truck drivers to HIV emerges from them being away from home and their
regular sex partners for long period of time [11]. A study from South India in 2009 reported
that truckers with higher income had higher number of sexual partners. Time away from
home, urban residence, income and marital status were the factors associated with their high-
risk sexual behaviour [12]. A survey from West Bengal revealed that nearly 86% of the truck
drivers had sex with a casual female partner other than their wives in the last 6 months [13].
Keeping such vulnerabilities into consideration, the National AIDS Control Program (NACP)
established drop-in-centers specifically at truck halt points [14]. HIV awareness program,
testing, treatment facilities for sexually transmitted infections (STIs) and creating an enabling
environment constituted the bouquet of services offered from these TI sites [14]. Despite
such initiatives, delayed linking of truckers to HIV test and treatment has been noted [15]. As
with truckers, vulnerability of adolescents and young adults to HIV in India has also been
documented although they did not feature in the MARP groups. Such vulnerabilities of the
youths arise either from their patronage to FSWs or exploration in unsafe drug use practices
[16]. A study in 2014, among adolescents (15–19 year) in Delhi, the capital city, revealed
that more than 45% of them were exposed to high-risk sexual behaviors [17]. However,
studies in the recent times focusing on the vulnerability of truckers and youths to HIV have
been few. Noticeably, HIV self-test has the potential to play a key role for these population
groups where the threat of infection does not appear obvious to individuals.
The World Health Organization (WHO) defines HIV self-test as a process in which a person
collects his or her own specimen (oral fluid or blood) and then performs a test and interprets
the result, often in a private setting, either alone or with someone he or she trusts [18].
Different countries are in varying stages of acceptance of HIV self-test. Implementation of
HIV self-test is still not without controversy and debate. While, several countries have
:
already introduced or are contemplating introduction of HIV self-test as part of their national
strategic plans, India, at present, is yet to do so [19]; studies focussing on acceptability of
HIV self-test across different population groups have also been limited. Investigations on
women in active or early labour and pregnant women, revealed that the participants preferred
undertaking HIV oral self-test over blood [20, 21]. To the best of our knowledge, no studies
exist on HIV self-test among truck drivers and youths in India. Against this background, we
undertook this investigation to assess the acceptability of HIV oral self-test (HIVOST)
among truck drivers and young adults in the country.
Methods
The current qualitative investigation was conducted in the district of Pune, Maharashtra,
during June through December 2019. Approval from the Institutional Ethics committee (IEC)
of the Indian Council of Medical Research-National AIDS Research Institute (ICMR- NARI)
was obtained before enrolment started. Prior to initiating in-depth-interviews (IDIs) and
group discussions (GDs), written informed consent was obtained from each of the
participants. INR 150 (2.5$) per person was provided at the end of each session as
compensation for travel. While presenting data, we have used pseudonyms in this article to
maintain confidentiality of the participants. All the enrolled participants were aged 18 year or
above. An HIV oral-self test (HIVOST) kit named Morcheck, a product of Morsef
Lifesciences Private Limited and manufactured by Bhat Biotech Private Limited was used as
a prototype to facilitate interactions around it.
Gaining access
Sevadham Trust is a Civil Society Organization (CSO) that works as a TI-partner of the
Maharashtra State AIDS Control Society and reaches out to the truckers and migrant workers
with HIV intervention. The organization has been working for this cause in Pune over the last
two decades. A field assistant, with experience of working earlier with Sevadham Trust,
organized IDIs and GDs with truckers from various translocation sites in Pimpri Chinchwad
Municipal Corporation (PCMC).
In order to recruit young adults in the study, local youth clubs were contacted. These clubs
serve as common platform where youths meet, discuss and plan activities for their future
development. The field assistant contacted such youth clubs in various geographical locations
to facilitate enrolment of participants with diversity. Additionally, a computer training centre,
managed by a private information technology (IT) solution company, was engaged for
recruitment of youths. Some of the young women were recruited through self-help groups
(SHGs). Other gatekeepers engaged in recruitment of young adults in the current study were
community influencers including a primary school teacher. Such recruitment approach
helped us in recording different community voices.
:
Eligible and willing individuals were informed by the field assistants to participate in the
current study. The team consisting of a moderator and a note-taker then came to the
identified site for conducting IDIs and GDs. Those participating in IDIs were not invited for
GDs so that wider range of responses could be obtained; GDs allowed capturing the
viewpoints emerging through interaction between the group members, which otherwise
would not have been possible through interviewing an individual.
The guides and probes used during in-depth- interviews and group discussions were
developed by the team at ICMR-NARI based on identified domains requiring exploration and
were administered in Marathi and Hindi. These tools underwent trial sessions and were
modified for ease of comprehension and correctness of content (Supplementary file 1). The
following domains were explored; ‘health seeking behaviour’, ‘prior HIV test experience’,
‘choice of HIV self-test’, ‘perceived advantages and disadvantages and apprehensions’.
Information was also collected pertaining to the packaging of the kits, presentation,
information to go with the kit, how-to-do instructions and preferred kit outlets.
Data collection
The research team received multiple orientations on research methodology during the study
period. These were conducted by the experts from social science background. Checklists
prepared for IDI and GD were used by the research team (a moderator and a note-taker
dedicated for a specific group of participants), which helped in ensuring consistency [22].
The field assistants ensured that the participants were from the similar socio-cultural
background speaking the same native language.
Truckers were initially enrolled from Nigdi transport area, located in the PCMC area of
Pune. Following completion of 8 IDIs and 2 GDs among truck drivers at this location,
diverge responses ceased to be generated. The research team therefore, decided to conduct
data collection at other trans-shipment locations namely, Telco Campus and Moshi. IDIs and
GDs were conducted either at the transport offices or in a temple premise identified by the
field assistants. A total of 16 in-depth-interviews (IDIs) and 6 groups discussions (GDs) were
completed with the truck drivers.
Twenty-five IDIs (12 with young women and 13 with young men) and 9 GDs (4 with young
women and 5 with young men) were conducted with the youths. Most of the IDIs and GDs
took place either at rented locations or community halls or residence of the participants or
project office premise as preferred by the participants. Privacy was maintained at each of
these interaction sites; ensuring that no observing bystanders were present during these
sessions.
:
Data analysis
All interview and group discussion sessions were audio recorded and transcribed exact and
translated in English. This approach of using English as a common language was to capture
the essence of the responses. Data analysts subsequently checked for the quality of
translations so that the nuances expressed by participants in local languages were not missed.
We incorporated the Guba and Lincoln criteria to check for the quality of research (Table 1)
[23]. Acceptability of HIV self-test was explored by carrying out content analysis of both the
transcribed and translated responses. A separate codebook was developed for each of the
study groups based on the domains explored. Short descriptions of the codes and quotes
around them was compiled. This was reviewed periodically and reorganized to identify major
or minor themes (categories). The data analysts, with assistance from the research
supervisors and other team members helped to resolve the coding discrepancies, if any.
Among the other methods, in-vivo coding was used to capture the voices and concerns of the
study participants. The field notes prepared by the interviewers before and after their
interactions with study participants helped in gathering sufficient reflexivity. N-vivo software
(version 11.0) was used to help in organizing the responses and subsequent analysis.
Table 1
While some of the truckers were engaged in long-distance travel across the country,
movements of others were limited to the State of Maharashtra. All the IDI participants
among truckers were married and belonged to the age group 21 to 67 year. While one of
them was a science graduate, six had primary school level education, 4 had studied till 10th
standard and the remaining 5 had completed 12th standard of school education. Each of the
interviews lasted for 50–85 min. Each focus group with the truckers had 5 to 6 participants
and most of the discussions lasted about an hour; the longest taking 1 h and 40 min. The
discussants belonged to the age group 21–55 year; most were married and the level of school
education varied from 3rd to 12th standard.
All the participants were in the age group of 18 to 24 year. Majority of the women
interviewees had secondary school education and some completed graduation. Among the 12
young women interviewees; only 4 were married and home-makers. Among the unmarried
women, most were studying, one was at home and only one of them was involved with
income generating activity.
All the participating young men in IDIs and GDs were unmarried. Of the 13 young men
enrolled for IDI, 3 did not have school education beyond higher secondary (12th standard)
and four had completed graduation in subjects such as arts, science and engineering; five
others were continuing graduate studies. In-depth interviews with women lasted for 50 min to
1 h, while interviews with men lasted for 30–50 min.
Four GDs were held with young women (3 groups constituted by unmarried women and 1 by
married women); each involving 5 to 6 participants. Most of the women were studying;10th
standard to pursuing a degree at college; 2 of them were involved with income generation
activities. Each of these GDs lasted for about 45 min.
Each of the five GDs with young men lasted for about 65 min and each involved 4 to 7
participants. Their level of school education varied from 10th standard to graduation.
Members of only one group were involved with income generating activities, while the rest
were all students.
“He is afraid of going to hospital. What he says – individuals will see him – that’s
why, need not go to hospital – that’s why he does not come in front”
All married women IDI-participants (during pregnancy) and 2 unmarried women had HIV
test experience. A few women members in GDs had prior HIV test experiences as well.
Contrastingly, among the male participants, only one interviewee and 2 group discussants
reported experience of prior HIV test.
Difficulties faced by women during HIV test were of varying nature such as pain associated
with needle prick during blood drawing, panic associated with the volume of blood drawn,
fear of unknown as HIV test was undertaken for the first time and the hassle of detour from
one department to another in the hospital. Negative attitude of some of the health care
providers was another concern.
“That you know – take blood from finger, take blood from vein – I had much
trouble – take a lot of blood – they remove blood until tears come in eyes … … I
had never taken HIV test before delivery – but during pregnancy they took a blood
sample … but then I was scared a bit”
“ … .as many drivers are there, they all will benefit … actually, means driver line
is such that people have to go outside for work … all these diseases happen mostly
to driver people … mainly drivers are targeted … It (HIV self-test) will be useful
for us … it will be very useful for those in this field”
HIV oral self-test (HIVOST) concept was greeted by most of the young adults during IDIs
and GDs. Long queue, fear of getting identified by somebody known, stare from people, and
fear of breach of confidentiality at HIV testing centres were the reasons cited by young men
welcoming HIVOST. Some of them even indicated that HIVOST would enable one to take
the test at home and highlighted the ease of using it.
Advantage of using oral saliva-based test in children was highlighted by a married woman,
while another woman elaborated upon hesitation to discuss HIV even with a doctor and
highlighted the advantage of HIV self-test in such context. Women participants, without
:
prior HIV test experience, reflected upon their social interactions and highlighted how
HIVOST could be helpful. Situations cited by them encompassed young boys and girls
contemplating sex, pre-marital HIV test and familial level disputes. Some of the young men
mentioned that HIV self-test should be deployed in brothels and lodges before engaging in
sex (wrongful expectation).
“If – I get an easy option (choice) at home itself, then I will not waste (spend) my
time by going to the lab – If facilities are provided, then definitely there is no harm
in taking them – why to waste our time – while going outside, waiting in queue for
reports”
“I can do the self-test and it would be confidential. I can directly discuss with the
doctor - there is no need to tell anyone, or no need to write anywhere”
Specimen of choice
Saliva was preferred over blood by both the truck drivers and youths. ‘Ease of using saliva as
test specimen’, ‘lack of knowledge on how to draw blood’, ‘quick results’, ‘ability to do the
test by self’ and ‘fear associated with needle prick’ were cited advantages. Young women
preferred HIVOST compared with the traditional blood-based HIV test conducted in
laboratories or hospitals; a few of them did not express any preference for clinical specimen,
and very few preferred blood over saliva.
“There is no need to tell anyone – we ourselves can come to know if we have HIV
or not” -Gan, 28 year (TRUCKER 07)
In two of the group discussions with young men, rare viewpoints such as presence of HIV in
the blood and unknown accuracy of saliva-based test were put forth as justification to choose
blood over saliva. The other rare justifications were blood being internal (core) element of
the body would capture the presence of the disease at an early stage and possibility of using
the blood specimen taken for HIV test to conduct other investigations such as CD4 count.
“If doing from blood then you can know HIV, but you can also know CD4 count …
.or other things can be checked”
Societal harm
None of the youths during IDIs or GDs flagged societal harm as an issue that could arise
following introduction of HIVOST. A few though talked about judgmental attitude of the
society towards HIV.
“Means, as now what I said as the logo is very famous (HIV logo in the form of a
red ribbon) because where ever HIV word comes … at that place, this ribbon
comes ..., so basically this logo belongs to this (HIV). So may be someone notices
this, so the person in front may quickly start to think that the person has done
something. So, he needs this product. Sometime people do not think, that why are
you doing this – Means when a person sees something in front of him, so he quickly
starts to think about it”
“If we share about it with friends that I have such and such problem... even he is
very close to us, he may have friends to whom he can tell ... that your HIV test
result is so and so... then people start looking at you in a different way. And due to
this fear, one cannot talk about it (test) or one avoids to take this test”
Individual harm
“That person will be mentally disturbed – he will not understand what to do. If
some person is too emotional then he will do something to himself – means suicide
etc. Some person will go into depression (after HIV OST positive result)”
“They will be demoralized as soon as they get to know … first and foremost they
would get demoralized. Sometimes, they would say that they don’t even want the
tablets … since now, I have got the disease … I don’t need to take the tablets … it’s
better to die … if society comes to know about it tomorrow that I have got this …
then who do I face … what would I tell people at home”
Young men also brought up issues such as ‘leakage of information’ and ‘forced testing
during marital negotiation’. Very few participants expressed that prank could be played with
HIV self-test. Accuracy of the HIV self-test result was another concern raised by some of the
young men and women
“I don’t know about its accuracy – It’s new test right. You will have to prove it first
then only you can bring it in market. Everyone should be aware of its accuracy”
A rare point of view was raised pertaining to the fluid (reagent) in the tube that comes with
the HIVOST-kit, by a truck driver from Punjab. He mentioned that the fluid could be used for
injections by drug users while, a young male interviewee assumed that the fluid might
contain acid and could be poured on to someone to cause harm.
Environmental harm
:
A few youths were concerned about safe disposal of the test kits, failing which could result in
environmental pollution. A few truckers were also concerned about disposal of test kits vis-à-
vis environmental pollution. Inappropriately disposed self-test kits in the garbage was seen
by another truck driver as an issue concerning risk to others’ health.
““Little bit it will affect the environment, and also pollution will take place –
because we throw it in the garbage – basically there is not one as such – if you go
to their work place and see that they set it on fire, and from that air pollution is
caused,”
“If this test comes in the market then everyone will know about it – we can’t throw
it there. Someone will see it while emptying the garbage there or while throwing
the garbage if someone sees it—they will come to know”
Kit considerations
Participants were shown various components of the HIV self-test kit and the package insert
with pictorial diagrams on ‘how-to-do’ steps. The following domains pertaining to kit
consideration were explored (Table 2); a) packaging, b) instruction leaflet, c) kit outlet, d)
cost consideration, and e) information to go with the kit.
Table 2
Kit considerations
:
DOMAINS QUOTATIONS
PACKAGING “Kit looks a little big, sir ... It should be a little small ... one that can
easily fit in the pocket”
“Name (what for) should be written only. -it should be known only”
HOW TO DO IT - “I would like to know if someone explains. But if pictures are displayed
INFORMATION in a different way then it’s okay. If it is shown in hospitals how to do it,
it would be much better. If explained in local Marathi language then it
would be of benefit”
“As you can see in “Save the girl child and educate her (Beti bachao,
Beti Padhao) … .on the television … in the same way it (HIV self-test)
can also happen … it should happen for this (HIVOST). That means
every home...it should be known that there is such kind of thing is
there. While sitting at home you can check / test. For this more
advertisement should be made”
ACCESS POINTS “It should be available everywhere – at Dhaba, at Pan Stall. It should
be made available in the hospitals and even at your office – your
department – It should be available in all these places”
COST “If it is kept for free then it would not be so much – people would not
understand its importance – so at least some price should be fixed”
Most of the youths considered taking HIVOST in the privacy of their bedroom or other
places home as appropriate, while truckers preferred taking it at ‘Khushi clinics’ or in the
vehicle. Easy availability of the kits at various halt points such as ‘toll nakas’ and ‘dhabas’,
were the felt needs of the truck drivers. Youths recommended making kits available at
schools and colleges. Wastage and mischievous use of kits, when made available free of cost,
were the apprehensions of the youths and truck drivers. The suggested price tag for a kit
ranged from INR 10 to INR 400.
Discussion
This qualitative investigation explored issues around HIV self-test from the perspectives of
truckers and youths; two vulnerable population groups in India. The country is committed to
the global goal of ‘ending AIDS by 2030’ [24] and the National AIDS Control Program
(NACP) in India is working towards it. However, the major challenge is to encourage people
to know their own HIV status, could be linked with anti-retroviral treatment facilities. A
systematic review of 23 studies by Figueroa et al. reported high acceptability of HIV self-
tests among key population groups such as MSM, FSW, TG, PWID and people in prison
[25]. The issue nonetheless has not been studied adequately among certain vulnerable
populations such as youths and truck drivers. The present investigation, being qualitative in
nature and examining acceptability of HIVOST, therefore stands out as an important
initiative.
Both truckers and youths, during our inquiry, welcomed HIV self-test. Truck drivers from
Hyderabad in Andhra Pradesh accepted oral HIV self-test as an innovative HIV intervention
approach. Most of the truck drivers were even willing to undertake HIV self-test while
available [26]. Studies focusing on HIV self-test among youths in India are sparse. A
qualitative study from Malawi and Zimbabwe among 16- to 25-year-old reveals that HIV
self-test was preferred provided it was available free or at low cost [27].
In the current investigation, saliva-based HIV self-test was preferred over blood. The
advantages cited were freedom from fear of needles and ability to do the test by self. A study
conducted among in-patients and out-patients at the rural teaching hospital in Sevagram,
Maharashtra recorded preference for oral-fluid over the blood-based HIV self-test [28].
However, scepticism on accuracy of HIVOST and the need for establishing linkages with the
post-test counselling services were expressed by some of the participants in the current
investigation as was noted by other researchers [29–31].
:
The present investigation revealed the discomfort of the participants to go to government
hospitals for HIV testing; loss of privacy and apprehension about breach of confidentiality
were the concerns. Contrastingly, truckers undergoing HIV test at Khushi clinics, located at
trans-shipment sites, found the arrangement user-friendly. Woodford et al. elaborated upon
the barriers to HIV testing at individual, inter-personal, socio-structural and health care
levels among the MARP groups in Chennai, Tamil Nadu in India. Stigma associated, not
only with the disease, but also HIV-test per se was cited as hindrance to access test services.
Participants in this study also feared discrimination from the community and society, which
delayed their access to HIV-tests. Timings, long queue, and extended waiting period were
other deterrents for accessing these facilities [32], which were similar to our findings.
Noticeably, most of the youths except young married women (who got tested for HIV during
ante-natal check-up), in our study did not have a prior HIV test experience.
The participants in the current study reported some apprehensions around HIVOST such as
accuracy of the results, disposal of kits, and self-harm. These findings were similar to the
concerns raised by the MSM and TG populations around in Pune, Maharashtra in India [33].
During current inquiry, the truck drivers wished that they could get HIV self-test kits at
common halt points; reportedly, they would prefer using them either at the trucker-friendly-
clinics (such as Khushi) or in the vehicle. A study from Kenya, among truck drivers,
recruited from wellness clinics, highlighted that those, who never undertook an HIV test
would prefer HIV self-test [36]. Young adults in the current study mentioned that they would
prefer taking HIV self-test in privacy of their homes. This was similar to the findings
emerging from South Africa. In Mozambique, adolescents preferred taking the test at youth-
friendly clinics [37–39].
HIV self-test has been in discussion for more than a decade [40]. However, a number of
countries are still weighing the pros and cons of introducing HIV self-test in their policies.
India is still debating its inclusion in the program. We hope that the evidence generated
across different population groups, as with the current investigation, assist the national
program in implementation of HIV self-test.
:
Limitations
This is a small-scale acceptability study that was conducted among truckers and youths in the
district of Pune, representing only a sub-section of the study population. We enrolled truckers
halting at the translocation points, which were selected as recruitment sites. However, such
recruitment strategy could not include the truckers who were not accessing these HIV
outreach program sites. Similarly, the young people, who did not attend the venues used for
recruitment, could not be included. Other studies from different geographical and socio-
cultural settings would help in obtaining diverse views and overcoming the aforementioned
limitations.
Conclusion
We conclude that HIV self-test will have acceptability among truckers and young adults in
Indian setting. The participants expressed their enthusiasm to use such a test as the results
could be quickly obtained and one could do the test on his or her own. However, it will be
necessary to address existing apprehensions around HIV self-test and pair such initiatives
with interactive strategies to mitigate misconceptions about HIV test and treatment.
Community voices captured through the current qualitative investigation underline the
necessity of such programmatic initiatives.
Supplementary Information
Additional file 1. Guides for In-depth Interview and Group Discussion.(25K, docx)
Acknowledgements
Abbreviations
:
CSO Civil Society Organization
GD Group Discussion
IDI In-depth-interviews
IT Information Technology
TI Targeted Intervention
:
TR Truckers
YB Young Boys
YG Young Girls
Authors’ contributions
AR: Investigation, analysis, validation & writing draft; SP1: Investigation, analysis,
validation & writing draft, PPK: Analysis & quality check of the interviews; ASD: Analysis
& quality check of the interviews; SSB: Investigation & validation; DDU: Investigation &
validation; RA: Supervision & project administration; SP2: Conceptualization, supervision,
project administration, analysis & writing draft. All authors read and approved the
manuscript.
Funding
This project was funded by World Health Organization grant (Technical Service Agreement:
2018/868515). The funding body did not play a role in study design, data collection, analysis,
interpretation and writing of the manuscript.
Due to the sensitive nature of the questions asked in this study, the survey respondents were
assured that the raw data will remain confidential and will not be shared. The data will not be
available on public domain. However, if a valid request is made to the corresponding author,
the data will be made available through official email communication.
Declarations
Ethics approval and consent to participate
This study was approved by Institutional Ethics Committee of ICMR-NARI (NARI /EC/
Approval /2019/259 dated 8/3/2019).
:
This study was performed in line with the principles of the Declaration of Helsinki. Written
informed consent was obtained from all the participants.
Not applicable.
Competing interests
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional
affiliations.
Contributor Information
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