Co‑creation of HIVST delivery approaches for improving urban men’s engagement with HIV services in eThekwini District, KwaZulu‑Natal : nominal group technique in intervention development

Abstract

BACKGROUND : HIV self-testing (HIVST) is one of the recommended approaches for HIV testing services, particularly for helping reach populations who would not normally access facility-based HIV testing. Key stakeholder engagement is paramount in tailoring health interventions to ensure uptake by target populations. OBJECTIVE : The main objective of this study was to collaborate with key stakeholder in the co-creation of an accept‑ able HIVST delivery strategies to help improve urban men’s engagement with HIV services. METHODS : We invited key stakeholders for urban men’s HIV services to participate in a co-creation workshop aimed at developing HIVST delivery approaches for urban men, using eThekwini municipality as a study setting. We conducted purposive sampling to include health care users and health care providers, representing a range of views across the public sector and voluntary sector. We employed the nominal group technique (NGT) method for data collection. The NGT workshop was conducted in two consecutives: phase 1 was focused on determining barriers for men’s engage‑ ment with the current/facility-based HIV testing services; phase 2 was aimed at determining HIVST delivery strategies. RESULTS : Participants identifed the following factors as the most important barriers to uptake of HIV testing services by urban men: stigma, ignorance about the importance of testing, and testing process as well as fear of positive test results. Key stakeholders suggested internal motivation strategies as a potentially efective approach to support HIVST delivery strategy. Guided by the NGT results, we designed a HIVST delivery strategy that is supported by a risk com‑ munication approach. CONCLUSION : The NGT enabled successful collaboration with key stakeholders in the co-creation of HIVST delivery strategies to guide implementation and strategy improve urban men’s engagement with HIV services. A follow-up study to evaluate the feasibility of implementing these approaches is recommended.