Facilitators, Barriers, and Recommendations for Overcoming Challenges to HIV Self-Testing Uptake among Homosexual Men in Asia: A Meta-Synthesis

This paper aimed to identify the facilitators, barriers, and recommendations for overcoming challenges to HIV self-testing (HIVST) uptake among men who have sex with men (MSM) and transgender (TG) people in Asia. Using a systematic search strategy, databases including PubMed, OCLC, EBSCOhost, Google Scholar, SABINET Online, Union Catalogue of Theses and Dissertations, WorldCat Dissertations, and ERIC were searched. The Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approach was used to analyse the findings. The results suggest that HIVST is perceived as a more confidential and easier method compared to traditional HIV testing among MSM and TG individuals. HIVST can increase the reach of HIV testing services for MSM and TG individuals in Asia. Community-based organisations and community workers can facilitate HIVST among MSM and TG in Asia. However, the cost of test kits is a significant barrier to HIVST uptake. Additionally, counselling services make traditional HIV testing preferable than HIVST method among these populations. Overall, there is a lack of policy for supporting HIVST for MSM and TG in many Asian countries. There are concerns among users and stakeholders that HIVST may lead to mental distress, promoting recommendations to link mental health services in a way that protects users' privacy. Key Words: HIV self-testing, Uptake, Health system, Multi-stakeholder, Men who have sex with men.