Introducing HIV self-testing in Latvia – pilot for key groups
Main applicant and principal investigator
Anda Kivite-Urtane, PHD, MPH, Assoc Prof; Director, Institute of Public Health, Riga Stradins University
Evija Dompalma-Linuza, MSc, MPH; researcher, Institute of Public Health, Riga Stradins University; board member, NGO Baltic HIV Association
Inga Upmace, MD, researcher, Institute of Public Health, Riga Stradins University; chairwoman of the board, NGO Baltic HIV Association.
Santa Ansone, MD, Riga East University Hospital and Children’s Clinical University hospital, Latvia; researcher, Institute of Public Health, Riga Stradins University.
Latvia has the second highest rate of annually diagnosed HIV cases in the EU, combined with one of the lowest testing rates and an estimated 30% of HIV cases being undiagnosed. There is an urgent need to increase access to testing and linkage to care. HIV self-testing has so far not been available in Latvia.
The overall aim is to increase HIV testing and linkage to care in the country. The specific project objective is to assess the feasibility and acceptability of HIV self-testing as a novel approach to increase testing in the country. This will be done by piloting self-testing among five key and vulnerable groups (people who inject drugs, men who have sex with men, sex workers, survivors of violence and clients of social services), evaluating feasibility and acceptability of HIV self-testing (both among the five groups and among relevant stakeholders), and disseminating study results within the scientific community, among stakeholders and in the general population.
Written guidelines for performing an HIV self-test will be developed and included in the self-test kits. 10 employees of selected low-threshold services (reaching the selected target groups) will be trained in providing counselling in connection with distributing the self-testing kits. 250 people from the five key groups will be recruited for the study through convenience sampling. The trained staff will distribute a test kit for each of the 250 people, along with a printed anonymous questionnaire (which can also be filled in online) and a pre-paid envelope for returning the questionnaire. This quantitative part of the study will be carried out as a cross-sectional study, aimed at assessing acceptability of HIV self-testing. The qualitative part of the study will assess feasibility of introducing HIV self-testing as well as the acceptability. This part of the study will be based on semi-structured in-depth interviews with 10-15 members of the key groups recruited to the piloting of self-tests, as well as 7-12 stakeholders (policy makers, public health administrators, healthcare professionals, social workers and NGO representatives). Participants of qualitative interviews will be recruited through maximum variation sampling.
Output / impact
This will be the first study to assess the feasibility and acceptability of HIV self-testing in Latvia. The project will pilot HIV self-testing as a new testing technology in the country, train staff from different low threshold facilities in providing counseling for HIV self-testing and establish a network of organizations for distribution of self-tests. The project aims to generate scientific evidence (in the form of a study report, two conference abstracts, a peer-reviewed publication, a media briefing and press releases), which will be disseminated to the scientific community, stakeholders and lay society in various ways and used to advocate for HIV self-testing to be included in national testing policies.