Kenya (2013-2014): Insights into Packaging and Labeling for HIV Oral Self-Test Kits in Kenya. Round 1

BACKGROUND HIV continues to be a public health concern in Kenya. Out of an estimated 40 million people the national HIV prevalence among adults aged 15-64 years was 7% as of 2007 representing an estimated 1.4 million people living with HIV (Republic of Kenya 2009). According to the Kenya AIDS Indicator Survey (KAIS) and Demographic Health Surveys (DHS), significant differences in HIV prevalence occur throughout the population and geographic locations. Women are at a greater risk (8.4%) than men (5.4%), and there is a greater than 15-fold variation in HIV prevalence among provinces, ranging from 1% in North Eastern province to 15.3% in Nyanza province (KNBS and ICF Macro 2010; National AIDS Control Council [NACC] 2009a; Republic of Kenya 2009). Despite wider provision of HIV testing services, and a high level of knowledge about HIV testing (95% of adults and 88% of youth know where to get an HIV test) (KDHS 2008-9), only 72% of adult Kenyans report having ever tested for HIV and received their results (KAIS, 2012). STUDY RATIONALE Oral HIV self-testing presents an opportunity to increase testing coverage by addressing barriers to HIV testing in VCT and facility based testing (i.e. limited access to VCT centers and hours of testing, HIV-related stigma and discrimination). Population Services International, Kenya (PSI) was awarded by the International Initiative for Impact Evaluation (3ie) and the National AIDS and STI Control Programme (NASCOP) to conduct a formative study on potential HIV oral self-test kit users, and messaging for HIV oral self-test kits. The purpose of this study was to identify willingness to use oral self-test kits, and factors associated with the potential adoption and use of oral HIV self-testing kits to inform future HIV self-testing pilot progr ams. The objectives are to determine likely users of oral HIV self-test kits, incentives to use a self-test kit, and identify key messages and approaches that could increase demand for the kits. The evidence from this study will inform the design and implementation of oral HIV self-testing pilot projects throughout Kenya; and national policy regarding the availability, cost/subsidies, quality control and procurement. METHODOLOGY This mixed-method study was conducted between November and December 2013 in two provinces/counties of Siaya (rural) and Mombasa (urban). The study population included 782 sexually active men and women aged 18 to 49 from the general population (GP); 100 men who have sex with men (MSM), and 100 female sex workers (FSW).