Willingness to use HIV self-testing among female sex workers in Malaysia


BACKGROUND: Although research on HIV self-testing (HIVST) has rapidly increased, few studies have explored information related to HIVST uptake in female sex workers (FSW), and none in Malaysia. Therefore, we endeavored to assess willingness to use HIVST in this at-risk, vulnerable population.
METHODS: A cross-sectional, quantitative study was conducted among 113 HIV-negative Malaysian FSW in 2017. Participants were recruited using advertisements on social media, flyers, and direct referrals from community-based organizations serving FSW and transgender women (TW). Data was collected using self-administered surveys. Multivariable logistic regression was used to identify correlates of willingness to use HIVST.
RESULTS: Nearly a third of participants (30.1%) reported they would be willing to use HIVST. Multivariable analyses adjusting for stable housing, living in Kuala Lumpur (KL), years in sex work, age of first sex work, childhood sexual assault, and previously in prison indicated that living in KL (adjusted odds ratio [aOR]=5.214, p=0.0137) was associated with a greater willingness to use HIVST. In contrast, having stable housing (aOR=0.100, p=0.0064) was negatively associated with willingness to use HIVST.
CONCLUSIONS: Findings in this study display essential data regarding FSW's self-perceived willingness to use HIVST in Malaysia. Overall, our results indicate that HIVST has moderate potential to enhance uptake and retention of HIVST in FSWs, especially for those who reported living in an urban environment. This highlights the need for additional research on effective implementation for HIVST for key populations, including FSW, at risk for HIVST.