Expanding youth-friendly HIV self-testing services during COVID: a qualitative analysis of a crowdsourcing contest in Nigeria


BACKGROUND: HIV self-testing (HIVST) among youth is an effective and confidential approach to enhance uptake. However, optimal strategies for delivering HIVST are limited, and the COVID-19 pandemic has disrupted facility-based HIV testing services. This qualitative study aimed to find common themes in a virtual World AIDS Day (WAD) crowdsourcing open call for youth responses on how to promote HIV self-testing among young people in Nigeria during COVID-19 measures.
METHODS: From October to December 2020, the 4 Youth by Youth WAD 2020 crowdsourcing open call was held virtually due to the COVID-19 pandemic. The open call followed WHO standardized steps. Nigerian youth participants aged 10-24 years old submitted ideas online through Google form or email to answer the question: 'How will you promote HIV self-testing among young people during COVID19 measures?' Data and responses from each submission were analyzed, and proposed ideas were closely examined to identify common themes. Four independent reviewers judged each submission based on Desirability, Feasibility, and Impact on a 9-point scale (1-9 with nine as highest).
RESULTS: The virtual WAD open call received a total of 156 entries, with 82% (128) through Google form and 18% (28) by email. Twenty submissions received an average total score of 7.5 or above. The steering committee ultimately selected three finalists. Three prominent themes were identified from the open call submissions to promote HIVST through: 1) digital approaches (such as gamification and photo-verification system) to decentralize testing beyond facility-based sites while adhering to COVID-19 safety measures; 2) community leaders and social influencers (such as religious and youth leaders) to build trust in HIV testing services; and 3) mobile service delivery through existing infrastructures/platforms (such as mobile health clinics, churches, schools, and health facilities) to sustain HIVST service delivery post-COVID-19 era.
CONCLUSIONS: The open call engaged a large, diverse number of youth through virtual connections. The open call participants proposed a variety of approaches and ideas to improve the uptake of HIVST for the HIV susceptible youth in Nigeria.