The mediating effect of individual beliefs between self-testing knowledge and HIV self-testing use

Abstract

Background: HIV self-testing has been introduced as a secondary mode of testing in most countries as a way of counteracting the barriers associated with the traditional clinic-based method of testing. As the entry point into the HIV care cascade, testing signifies a unique contribution in the fight to end HIV by 2030. However, in Uganda, the uptake of self-testing services remains contested, especially in low-skilled communities. Using the health beliefs model constructs of individual beliefs (perceived susceptibility, benefits, and barriers), the current study examined the effect of individual beliefs as a mediating factor between HIV self-testing knowledge and use.Methods: A cross-sectional survey was conducted (July to September of 2023), with a systematic and random sample of 453 unskilled workers from Darling, Wakiso district, Uganda. The data were collected using a structured, validated, self-administered questionnaire. Data were analysed using regression mediation analysis in Process Macro Model 4 in SPSS v27.Results: Perceived susceptibility (β = 0.06, Boot 95% [0.03, 0.10]) and benefits (β = 0.06, Boot 95% [0.24, 0.39]) mediated HIV self-testing knowledge and HIV self-testing use. Perceived barriers (β = 0.01, Boot 95% [0.00, 0.03]) did not mediate HIV self-testing knowledge and HIV self-testing use.Conclusion: In addition to delivering knowledge about self-testing, the benefits of using HIV self-testing and the susceptibility nature of individuals in low-skilled employment should be given more attention as a means to increase HIV self-testing.

Keywords: HIV prevention; HIV self-testing; HIV self-testing knowledge; HIV self-testing use; individual beliefs; unskilled workers.