HIV testing experiences in Nairobi slums: the good, the bad and the ugly.
BACKGROUND
HIV testing is an integral component of HIV prevention, treatment and care and, therefore, is crucial in achieving UNAIDS 90-90-90 targets. HIV testing in Kenya follows both the voluntary counselling and testing (VCT) and provider initiated testing and counselling (PITC) models. However, little is known about the individual experiences of undergoing an HIV test in the two testing models. This study provides experiential evidence of undergoing an HIV test in a resource poor urban slum setting.


METHODS
The study explored testing experiences and challenges faced in respect to ensuring the 3 Cs (consent, counselling and confidentiality), using in-depth interviews (N = 41) with HIV-infected men and women in two slum settlements of Nairobi City. The in-depth interview respondents were aged above 18 years with 56% being females. All interviews were audio-recorded, transcribed and then translated into English. The transcribed data were analysed using thematic analysis method.


RESULTS
The respondent HIV-testing experiences were varied and greatly shaped by circumstances and motivation for HIV testing. The findings show both positive and negative experiences, with sporadic adherence to the 3Cs principle in both HIV testing models. Although some respondents were satisfied with the HIV testing process, a number of them raised a number of concerns, with instances of coercion and testing without consent being reported.


CONCLUSION
The 3Cs (consent, counselling and confidentiality) principle must underlie HIV testing and counselling practices in order to achieve positive testing outcomes. The study concludes that adherence to the 3Cs during HIV testing contributes to both the individual and public health good - irrespective of whether testing is initiated by the individual or by the health provider.
['Wekesa|Eliud|E|http://orcid.org/0000-0003-0830-2487']
D015492:AIDS Serodiagnosis D000293:Adolescent D000328:Adult D002947:Cities D003068:Coercion D003219:Confidentiality D005260:Female D015658:HIV Infections D006801:Humans D007630:Kenya D008297:Male D008403:Mass Screening D008875:Middle Aged D009042:Motivation D017060:Patient Satisfaction D011204:Poverty Areas D014505:Urban Population D055815:Young Adult
HIV testing Slums Kenya VCT PITC PLWHA sub-Saharan Africa