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Launching HIV self-testing in a multicultural setting in Cameroon

2020; Elsevier BV; Volume: 20; Issue: 3 Linguagem: Inglês

10.1016/s1473-3099(20)30050-5

1474-4457

François‐Xavier Mbopi‐Kéou, Ginette Claude Mireille Kalla, Paulin Anankeu, Jean‐Emmanuel Pondi,

HIV/AIDS Research and Interventions

People living with HIV in western and central Africa are often unaware of their HIV status.1UNAIDSUNAIDS data 2018.http://www.unaids.org/en/resources/documents/2018/unaids-data-2018Date: 2018Date accessed: July 26, 2018Google Scholar To address this issue, HIV self-testing, an approach developed in 2014, should be incorporated into implementation strategies for a more efficient fight against HIV. On May 15, 2019, HIV self-testing was launched in Ngog Mapubi, a remote, rural health district of the Centre Region of Cameroon (figure). We aimed to evaluate the sociodemographic and behavioural factors associated with acceptability of supervised HIV self-testing among the local population, including students, using a specifically designed questionnaire. Individuals aged 15 years or older who provided verbal consent were included in our study. Participants were trained to use an HIV self-test (Exacto Test HIV; Biosynex, Strasbourg, France).2Tonen-Wolyec S Batina-Agasa S Muwonga J Fwamba N'kulu F Mboumba Bouassa RS Bélec L Evaluation of the practicability and virological performance of finger-stick whole-blood HIV self-testing in French-speaking sub-Saharan Africa.PLoS One. 2018; 13e0189475Crossref PubMed Scopus (27) Google Scholar, 3Tonen-Wolyec S Mbopi-Keou FX Koyalta D Filali M Batina-Agasa S Belec L Human immunodeficiency virus self-testing in adolescent living in sub-Saharan Africa: an advocacy.Niger Med J. 2019; 60: 165-168Crossref PubMed Google Scholar The testing procedure was also translated into the local Bassa language. The questionnaire was redacted according to guidance on how to implement HIV self-testing in the most ethical, acceptable, and effective manner, as proposed by WHO.4WHOReport on the first international symposium on self-testing for HIV: the legal, ethical, gender, human rights and public health implications of self-testing scale-up. World Health Organization, Geneva2013Google Scholar 322 individuals fulfilled the inclusion criteria, of whom 195 (61%) were female and 127 (39%) were male. 252 (78%) participants were single. The mean age of participants was 22 years (SD 8; range 15–62); 230 (71%) were young students (aged ≤24 years). 262 (81%) participants reported having more than one sexual partner; among them, 51 (16%) regularly had sex without using condoms during the previous 6 months. 249 (77%) of 322 participants had never received HIV counselling or testing before and 80 (25%) could only understand the HIV self-testing procedure in the local Bassa language. 320 (99%) participants found the HIV self-testing socially acceptable and 316 (98%) could do the test. HIV self-testing circumvents many of the logistical and stigma-related barriers associated with traditional testing methods and makes learning your HIV status simpler, more private, and more convenient. The anonymity offered by self-testing and its high acceptability offer great promise for increasing knowledge of HIV status and improving the efficiency of testing services by reducing burdens on health facilities and health-care workers. Furthermore, contrary to what is usually stated by respected specialists in public health who claim that the use of official languages is the only approach to reach rural populations,5Mbopi-Keou FX HIV/AIDS pandemic in Africa: what should be the global response.in: Mbopi-Keou FX Health and sports in Africa: a challenge for development. John Libbey Eurotext, Montrouge2008: 25-37Google Scholar one of the keys to the penetration of African rural areas is the translation of medical literature into the local languages. This is particularly true for the HIV self-testing procedure. It is about time to reverse the thinking of those public health specialists who cling to the use of official languages only: there is no illiteracy once translation has been done. Bringing the test to a local population is a laudable initiative. The way forward is to make it affordable and readily usable by providing instructions in local languages. We declare no competing interests.