Factors related to the introduction of HIVST in the health care system
|To assess the perception of HIVST as a factor favouring and limiting the deployment of HIVST among key populations.||Public health stakeholders, association and representatives of key populations||15–20 in-depth interviews will be conducted in each country.||
Difficulties, opportunities and obstacles to the introduction of HIVST and its support system in the country’s associative and health system;|
Difficulties and obstacles related to secondary distribution;
Difficulties and obstacles specific to each population;
Perceptions of the support system (advice, green line, tools); Recommended adjustments for key populations.
|Sub-study 2: Collective attitudes and perceptions of HIVST||To analyse perceptions, motivations and barriers to use HIVST among key populations||Members of the three key population communities (FSW, MSM, PWuID), whether or not they have used HIVST, identified by peer educators from ATLAS partner community associations||
3 focus group discussions (FGDs) will be conducted with members of each key population in each country (i.e., 9 FGDs in Côte d’Ivoire, 6 FGDs in Mali and 9 FGDs in Senegal, i.e., 24 FGDs in total).|
Each group will be composed of 8 to 10 members of the key population under consideration.
Perceptions of HIVST (information circulating about HIVST in the community, opinions on the advantages/disadvantages of HIVST compared to routine testing, advantages/risks of introducing HIVST in each community);|
Motivations and barriers for HIVST (self-confidence to carry out the test, testing and testing offer practices, conditions under which HIVST can be accepted/refused, facilitating and limiting factors for the practice of confirmatory testing);
Motivations and barriers to secondary distribution;
Suggestions for promoting the practice of HIVST for each key population and in each country.
|Sub-study 3: Experience of HIVST||To analyse the use of HIVST, the social experience of HIVST users and linkage to care||
• identified by peer educators from the community partners of the ATLAS programme (primary distribution)
• identified via coupon survey (secondary distribution)
5 in-depth face-to-face interviews will be conducted per key population in each country.|
5 additional interviews will be conducted by phone with people recruited through the Coupons survey, who have declared that they have had a reactive self-test and have agreed to be recontacted for an additional qualitative interview during phase 2 of the Coupons survey in each country.
Recourse to HIVST (motivations, circumstances: primary or secondary distribution, perceptions of the process, screening itineraries before HIVST, satisfaction);|
Social experience (social context of implementation, relations with the applicant, violence or coercion suffered/exercised on the partner/girlfriend, stigmatisation, abuse, changes in terms of prevention strategies and social relations);
Difficulties and satisfaction (access to HIVST, implementation, suggestions).
|Sub-study 4: Appropriation and integration of HIVST||To explore the level of ownership of HIVST by key populations and key stakeholders and to analyse the integration into the health care system after at least 2 years of implementation of the ATLAS programme||Public health stakeholders, association and representatives of key populations||15–20 interviews will be conducted with the same type of stakeholders as those surveyed in sub-study 1 in each country||
Perceptions and attitudes at the end of the intervention (sub-themes similar to survey 1);|
Integration of the system and impact on the healthcare system;
Challenges of providing HIVST to key populations (compared to the general population).