Experience of social harms among female sex workers following HIV self-test distribution in Malawi: results of a cohort study

• DOI: 10.1186/s12879-024-09178-3
• Publication Date: 2024-03-11T11:06:25Z
• Authors: Paul Mee; Melissa Neuman; Moses Kumwenda; Wezzie S. Lora; Simon Sikwese; Mwiza Sambo; Katherine Fielding; Pitchaya P. Indra...; Karin Hatzold; Cheryl Johnson; Elizabeth. L. Cor...; Nicola Desmond
• Keywords: Malawi; Sociology and Political Science; Epidemiology; Coercion; Social Sciences; Logistic regression; HIV Infections; Infectious and parasitic diseases; RC109-216; FOS: Health sciences; B900 - Others in subjects allied to medicine; Cohort Studies; HIV Testing; Context (archaeology); 0302 clinical medicine; Sociology; Mass Screening; Prospective Studies; Internal medicine; Sub-Saharan Africa; Geography; Substance Abuse; Cohort; Social Harm; FOS: Sociology; Infectious Diseases; Archaeology; Medicine; Female; Social harm; Female Sex Worker; Family medicine; 610; 613; 03 medical and health sciences; HIV Self-test; Health Sciences; Machine learning; Humans; Global Epidemiology of HIV and Drug Use; Demography; Sex Workers; Prevention and Treatment of HIV/AIDS Infection; Research; HIV self-test; Intimate Partner Violence Objective; Global Impact of Sex Work and Trafficking; Computer science; Self-Testing; Regret

Abstract Background In Malawi, female sex workers (FSW) have high HIV incidence and regular testing is suggested. self-testing (HIVST) a safe acceptable alternative to standard services. This study assessed; whether social harms were more likely be reported after HIVST distribution FSW by peer distributors than facility-based regretted use or experienced associated relationship problems. Methods Peer distributors, who FSW, recruited in Blantyre district, Malawi between February July 2017. Among recipients prospective cohort was recruited. Interviews conducted at baseline end-line, 3 months later. Participants completed daily sexual activity diaries. End-line data analysed using logistic regression assess regret problems with use. Sexual Generalised Estimating Equations temporally an increase harms. Results Of 265 offered HIVST, 131 both interviews. these, 31/131(23.7%) initial use, this reduced 23/131(17.6%) the 3-month follow-up. Relationship 12/131(9.2%). Regret about less commonly those aged 26–35 years compared 16–25 (OR immediate regret—0.40 95% CI 0.16–1.01) current regret—0.22 0.07 – 0.71) not result. There limited evidence that reports of verbal abuse perpetrated clients week following greater when there no preceding week. for increases any other some coercion test, most initiated distributor. Conclusions Little found model increased levels harms, however programmes aimed reaching need carefully consider possible unintended consequences their service delivery approaches, including potential coerce individuals test disclose results models may considered.