Facilitators, Barriers, and Outcomes of Self-Initiated HIV Testing: An Integrative Literature Review

Background and Purpose: HIV testing is an essential tool for identifying people at risk for HIV infection and linking those who are infected to care. Despite the recommendation for routine HIV testing for people who are vulnerable to HIV infection, healthcare professionals experience difficulties initiating discussions related to sexual health and recommending HIV testing. Healthcare professionals not offering HIV testing is a frequently reported reason for delays in testing. Self-initiated HIV testing is understudied and vital to improving HIV testing rates, treatment, and the process of HIV prevention. The main aim of this integrative literature review is to identify facilitators, barriers, and outcomes of self-initiated HIV testing. Method: A search of PubMed, CINAHL, PsycINFO, EBSCO host, and Google Scholar, revealed 31 studies that met the inclusion criteria. Results: Self-initiated HIV testing is voluntarily requested and completed by individuals either using self-testing kits or in a setting that provides HIV testing. Perception of susceptibility to HIV infection, privacy, access to HIV testing sites or self-testing kits, and knowledge related to HIV infection and testing, were some of the salient facilitators and barriers to self-initiated HIV testing. Findings from our review indicate several benefits to self-initiated HIV testing, including early identification of acute HIV infection, increased likelihood for the uptake of HIV prevention interventions, and a reduction in sexual risk behaviors. Implication for Practice: Nursing initiatives geared toward promoting self-initiated HIV testing will lead to prompt diagnoses and linkages to treatment which will further improve nursing care and a variety of health outcomes.