Abstract

Trust in new biomedical technologies: beliefs about HIV self-test kits and biospecimens among truck drivers in Kenya who chose not to test

Aleya Khalifa¹, Joanne E. Mantell², Stephanie N. Christian³, Matthew L. Romo⁴, Michael Strauss⁵, Kaymarlin Govender⁵, Eva Mwai⁶, Eston Nyaga⁶, Jacob O. Odhiambo⁶, Gavin George⁵, Elizabeth A. Kelvin⁴ (1)Department of Epidemiology and ICAP, Columbia University, (2)HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, (3)University of Pittsburgh Graduate School of Public Health, Department of Behavioral and Community Health Sciences, Pittsburgh, Pennsylvania, USA, (4)Department of Epidemiology & Biostatistics and Institute for Implementation Science in Population Health, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA, (5)University of KwaZulu-Natal, Health Economics and HIV/AIDS Research Division (HEARD), Durban, South Africa, (6)The North Star Alliance, Nairobi, Kenya

APHA 2022 Annual Meeting and Expo

Introduction: HIV self-testing (HIVST) can increase testing rates in mobile populations like truck drivers, but less is known about the beliefs that influence mistrust in new HIVST technologies.
Methods: We conducted in-depth interviews with 24 truck drivers in Kenya who chose not to test for HIV within an HIVST-focused randomized controlled trial (RCT) in 2015, prior to the national rollout of HIVST. The RCT compared HIV testing uptake at baseline and over 6-months of follow-up between those offered only the standard facility-based finger-prick testing (SOC) and those offered a choice between the SOC test and an oral HIVST. We used purposive sampling to recruit participants who refused HIV testing at baseline (n=16) or who did not test during follow-up (n=8). We examined their interview responses to identify preferences, beliefs, and attitudes about oral versus blood-based HIVST kits.
Results: There was variation in preference regarding blood versus oral HIVST. Six participants reported that they preferred blood-based HIVST because they did not trust results from oral HIVST kits. Some attributed this to the belief that HIV cannot be detected in oral fluids: “…it’s the blood that carries. The blood is the one that has the disease. Others reported that they only trusted oral HIVST because of fear of needles in general or that the needles might be contaminated and cause disease.
Conclusion: Through in-depth interviews, we identified misconceptions that may influence trust in new HIVST technologies. Our study highlights the need for dissemination of correct information regarding oral HIVST to ensure that availability translates into uptake.