HIV counsellors' knowledge and attitudes on HIV self-testing: A qualitative study in Eswatini

Human Immunodeficiency Virus (HIV) self-testing (HIVST) expands access to HIV diagnosis and holds potential for reaching high-risk and hard-to-reach populations. In Eswatini, HIV counsellors play a key role in providing HIVST, yet their knowledge and attitudes towards HIVST remain underexplored.

This study aimed to explore the knowledge and attitudes of HIV counsellors in offering HIVST as a strategy to enhance targeted HIV services in Eswatini.

The study was conducted at the outpatient department of a regional hospital in Manzini, Eswatini.

A qualitative, exploratory-descriptive research design was used. HIV counsellors were sampled using all-inclusive sampling. Individual, face-to-face semi-structured interviews were conducted with 13 HIV counsellors. The interviews were audio-recorded and transcribed. Data were thematically analysed.

HIV counsellors demonstrated a comprehensive understanding of their roles and responsibilities in delivering HIVST and expressed generally positive attitudes towards this testing approach. Recommendations were made for improving HIVST.

The findings highlight the need for policymakers to prioritise the continuous professional development of HIV counsellors and equip them with strategies including mobile testing units and community-based HIVST distribution to reach marginalised high-risk populations within their specific area. Service delivery should integrate effective client feedback systems to improve HIVST, a continuously available support contact line, and government commitment to ensure consistent HIVST kit supplies to prevent disruptions in service delivery.

This study describes HIV counsellors in Eswatini's knowledge and attitudes towards HIVST in Eswatini.