HIV Self-Testing Kits Uptake in Mashonaland West Province, Zimbabwe, 2019-2020: A Secondary Data Analysis

Abstract

Background: Human Immuno-Deficiency Virus Self-Testing (HIVST) is a process where an individual who wants to know their HIV status collects a specimen, performs a test and interprets the result by themselves. HIVST data from the Zimbabwe AIDS and TB Program (ATP) directorate showed that between 2019-2020, only 31% of the target HIVST kits were distributed in the country. Mashonaland West Province was one of the least performing provinces in meeting targets for HIVST kits distribution. Gaps in the implementation of the HIVST in the province ultimately affect the nationwide scaleup of targeted testing, a key enabler in achieving HIV epidemic control. We analyzed HIVST trends in Mashonaland West Province to inform HIV testing services programming. Methods: We conducted a cross-sectional study using HIVST secondary data obtained from the District Health Information Software 2 (DHIS2) electronic database. We conducted regression analysis for trends using Epi Info 7.2 and tables, bar graphs, pie charts and linear graphs were used for data presentation. Results: A total of 31,070 clients accessed HIVST kits in Mashonaland West Province from 2019-2020. A slightly higher proportion (50.4% and 51.7%) of females as compared to males accessed HIVST kits in 2019 and 2020 respectively. Overall, an increase in the trend of HIVST kits uptake was recorded (males R2 = 0.3945, p-value = 0.003 and females R2 = 0.4739, p-value = 0.001). There was generally a decline in the trend of community-based distribution of HIVST kits from the third quarter of 2019 throughout 2020 (R2 = 0.2441, p-value = 0.006). Primary distribution of HIVST kits remained the dominant method of distribution, constituting more than half of the kits distributed in both 2019 (67%) and 2020 (86%). Conclusion: Mashonaland West Province was mainly utilising facility-based distribution model for HIVST over the community-based distribution model. We recommended training more community-based distribution agents to increase community distribution of HIVST kits.