Botswana: Pandemic Affects HIV Self Testing Roll-Out Plan

Serowe — The COVID-19 pandemic has curtailed Serowe District Health Management Team (DHMT) efforts to roll out distribution of HIV self-test kits.

In a recent interview, Serowe DHMT principal medical officer, Dr Onkgopotse Oduetse, said implementation of the self-testing initiative was to have started immediately after the training of health workers in November last year, but the exercise could not take off on time because of logistics issues and implementation only started towards the end of March this year.

Nonetheless, she pointed out that the programme again stalled when the country went into lockdown in April, noting that happened before mobilisation could be done.

Due to the initiative not having been adequately advertised to the community, Dr Oduetse noted that the DHMT did not, at the moment, have much evidence as to what the community's response to the self-test kits was.

She further noted that after lockdown, the need to adhere to COVID-19 protocols became a limiting factor since the DHMT could no longer go forward with its initial outreach plan of mass sensitisation, but would instead now target smaller groups such as church gatherings.

Despite the hiccups encountered at the initial stages of the programme, the HIV testing services focal person, Ms Keitumetse Noko, indicated that to date, Serowe DHMT had distributed 78 test kits from health facilities and 98 through clients on anti-retroviral therapy who had gone public about their HIV status.

Ms Noko, however, explained that, in an endeavour to intensify efforts to take the kit to communities, the DHMT embarked on a house-to-house sensitisation drive in Malatswae in June where kits were distributed to 16 individuals, whereas 27 of those reached indicated that they preferred the conventional way of testing.

Of the number of people to whom test kits were distributed, Ms Noko said only four of those who collected kits from health facilities had brought their results forth, whereas of those who collected from the clients on therapy, 95 had since brought in their results.

On what the DHMT did to ensure results were reported back, the focal person explained that follow-ups were done a week after collection of kits by way of reminders through phone calls.

This, she said, was not as effective as it turned out because some clients gave incorrect information when collecting kits, thus making it difficult for health officials to reach them to remind them to bring in their test results.

Ms Noko highlighted the importance of bringing in results after conducting the self-test because a reactive or positive result from the kit was not sufficient to make an HIV positive diagnosis.

"It is of importance to note that a reactive (positive) HIV self-test result is not sufficient to make an HIV-positive diagnosis. Self-testers with a reactive test result will need further testing from a trained provider using a validated national testing algorithm," she explained.

Giving a background of the self-testing initiative, Ms Noko stated that in the period between 2015 and 2016 testing uptake was reported at 83 per cent, a figure that showed that several population groups remained severely unreached with current testing approaches.

She noted that data also showed that some groups such as men and young people, were more affected than the rest of the population; and that men in particular had been repeatedly shown by statistics to be less likely to test for HIV.

Ms Noko said it was clear that simply increasing coverage of conventional testing approaches would only have a marginal effect on the current testing gap because the right population may not necessarily be reached.

"It was therefore seen critical to adopt testing modalities that will enable ease of access, and implementation of HIV self-testing was believed to have the potential to bridge this gap by offering individuals the opportunity to conduct the test in their own privacy, at their own convenient time," she said.

Source : BOPA

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