Introduction

HIV self-testing (HIVST) is emerging as a potential game-changer in the fight against HIV, especially in places like Lake Victoria, where traditional testing methods struggle to reach mobile populations. This innovative approach offers privacy and convenience, crucial for the highly mobile fishermen in this region. Our qualitative study dives deep into the knowledge and acceptability of HIV self-testing among these key demographics, revealing promising insights into a revolutionary health initiative.

Study Overview

Conducted between December 2021 and June 2022, our research engaged 65 fishermen through in-depth interviews and focus groups as part of the "Owete" study, aimed at boosting HIV testing in Kenya. Our focus was on men aged 18-34 and 35+, specifically targeting those identified as social network leaders who could serve as HIVST advocates within their communities.

Key Findings

The enthusiasm for HIV self-testing was palpable. Almost all participants had heard about it, and nearly half were introduced to the concept through the "Owete" initiative. Fishermen highlighted several advantages of self-testing, including increased privacy, convenience, and the ability to control the testing environment — factors that dramatically reduce stigma and work disruption.

Despite their knowledge, most had yet to utilize HIVST. Those who had tried it reported ease of use, but barriers remained. Concerns surfaced regarding the fear of positive results, uncertainty about proper testing procedures, and the stigma attached to possessing a self-testing kit.

Acceptance and Distribution Among Fishermen

The desire for self-testing was matched by a willingness among these fishermen to promote it within their networks. Almost all "promoters" indicated they would distribute HIVST kits to peers, emphasizing the importance of trust and relationship-building in initiating conversations around HIV testing. However, they also called for training to equip them for these sensitive discussions.

Fisherfolk commonly face barriers to facility-based testing due to travel and stigmatic perceptions associated with clinic visits. Additionally, norms surrounding masculinity often discourage men from seeking health services due to perceived vulnerabilities.

The Bigger Picture

Located in one of Kenya's highest HIV prevalence regions, the Lake Victoria area sees almost 6% of its adult population living with HIV. The local fishing community represents a high-risk group that disproportionately bears the brunt of the virus due to their mobile lifestyle and engagement in high-risk behaviors.

Men in sub-Saharan Africa are historically less likely to test for HIV than women, underscoring the urgency of innovative approaches like HIV self-testing to bridge this gap. In 2018, only 70.7% of men in Kenya had ever tested for HIV compared to 85.1% of women. The gap not only hinders men's access to life-saving interventions but stifles HIV prevention efforts as well.

Conclusion

This research highlights a critical opportunity: with high awareness and enthusiasm for HIV self-testing among fishermen in Western Kenya, combined with a peer-based promotion model, there's significant potential to boost HIV testing rates within this group. However, success hinges on addressing psychological barriers, increasing the availability of testing kits, and enhancing community education programs.

As we work towards greater engagement in HIV testing, it is crucial that we harness the power of social networks among these fishermen, ensuring they have the support and information necessary to make informed decisions about their health. The pathway to a healthier future is clear, and the fishermen of Lake Victoria are ready to take the first step in this transformative journey towards HIV prevention and care.

Stay tuned as we continue to follow this dynamic initiative and uncover more stories from the frontline of the fight against HIV in Kenya!