Prevalence and Factors Associated With
Utilization of HIV Self Testing Among

Students of Universities in South Western
Uganda.

Marvice Namandea, Andrew Natwijukaa, Dickson Agabaa, Allion
Asiimirea, Irene Kebeyia, Robert Mugumyaa, Jane Kabamia, Florence

Beinempakab, Allan Muhumuzaa,1
a Bishop Stuart University,

P.O.BoX 09, Mbarara City, Uganda.
Tel.: +256701682605

b Mbarara University of Science and technology,
P.O.BoX 1410, Mbarara City, Uganda

Abstract

Background
HIV self-testing (HIVST) is globally accepted as an important complement to existing HIV Counseling and Testing
approaches. This study aimed at determining the prevalence and factors associated with the utilization of HIV self
testing among university students of South western Uganda.
Methods
An online cross-sectional study design that used the quantitative approach was conducted purposely among 356
university students of Kampala International University (KIU) and Mbarara University of Science and Technology
(MUST) in South western Uganda between 12th August 2020 and 31st August 2020. Mapping different course leaders
in launching the Google form link that contained the structured questionnaires in their respective formal class
WhatsApp groups for enrolling potential participants. Descriptive analysis of numeric data was summarized in means
with standard deviations and presented using tables. Descriptive analysis of categorical data was summarized in
frequencies, proportions and presented using tables. Association between independent and dependent variables was
assessed using Chi square test (X2) for bi variate analysis in SPSS IBM version 20.
Results
Of the 356 participants, the study had 57.3% of the participants from KIU and 42.7% were from MUST. The study found
that university students who had ever self tested were 43.2 Socio demographic variables associated with utilization of
HIV self testing were the student’s year of study (p = 0.007), having a sexual partner (p = 0.012), and place of residence
(p = 0.000).
Conclusionsa
The study demonstrates low levels of utilization of HIV self testing among University students in association with a
number of factors that include how they are aware towards HIV self testing, places of their residence, having a sexual
partner.

adate submitted: 28-09-2021 date
accepted: 30-10-2021 email: amuhu-
muza@as.bsu.ac.ug



1 Introduction
Globally, 37.9 million people are living with HIV
of which 36.2 million people are more than 15
years old. The UNAIDS set 90-90-90 strategy by
2020 was not fulfilled given the increased popula-
tion number of people who were living with HIV
not knowing their status [1]. Related research in
Ghana indicates that the lifestyles of students on
university campuses are placing them at risk of
contracting the HIV [2] as the university environ-
ment has been shown to promote sexual activity
among the general student population [3]. It is
therefore not surprising that sexual intercourse has
become the most predominant mode of transmis-
sion of HIV in sub-Saharan Africa, accounting for
approximately 90% of all infections [4]. A 2010 HIV
sero-behavioural study in six universities in Uganda
showed that the HIV prevalence rate is estimated at
1.2 percent [5] and this contributes to the high rate
of youth in sub-Saharan Africa that were reported
to be unaware of their HIV status [6]. The increased
unawareness of youth’s about their status can be
addressed by increased coverage of HIV self-testing
(HIVST). HIV self testing has been defined a process
in which a person collects his or her specimen (oral
fluid or blood), performs a test, and interprets the
results; often in private or with someone they trust
and seen as an additional approach offered to HIV
testing services that would increase the number of
people knowing their status and reduce barriers of
HIV counseling and Testing (HCT) [7].
Studies have documented a lot of work on

HIV self testing, including acceptability, feasibility
among various categories of population including
university students with results showing high levels
of acceptability in these populations. Additionally,
HIV self-testing (HIVST) is globally accepted as an
important complement to existing HCT approaches,
and several countries including Uganda have al-
ready introduced or are considering the introduc-
tion of HIVST as part of their testing strategies [8].
Moreover, HIVST has the potential to facilitatemore
people getting tested because it has advantages
that seem to influence the uptake of HIV self testing
such convenience, speed, privacy, anonymity, confi-
dentiality, and accessibility. HIVST has the potential
to be an acceptable option for high risk popula-
tions who would otherwise not test for HIV using
currently available HCT services for various rea-
sons, including stigma [8]. Benefits of the HIVST

are in the positive face of World Health Organiza-
tion (WHO) HIV testing guidelines and have played
an important in narrowing the gaps and challenges
in the global HIV testing coverage [7].
The utilization of HIV self testing is driven by a

number of factors that contribute to the self testing
practice among youth. To the university student
populations previous studies have focused on the
acceptability, feasibility and perceptions they have
towards HIV self testing. This has left a very big gap
on pointing out the factors that drive the uptake
of these HIV self testing services. Therefore the
study’s main objective was to determine the preva-
lence and factors associated with the utilization of
HIV self testing among university students of South
western Uganda.

2 Methods
Study design
A cross-sectional study design that used a quan-

titative approach to study prevalence and factors
associated with utilization of HIV self testing among
University students. The study took place between
12th August 2020 to 31st August 2020
Study setting
The study was an online study which targeted

two Universities in South western Uganda (Kam-
pala International University Western Campus (KIU-
WC) and Mbarara University of Science And Tech-
nology (MUST)). Mbarara University of Science and
Technology is the only public university found in
Mbarara city accredited by the National Council for
Higher Education (NCHE), Uganda. This University
commenced its intake way back in 1989 and it has
two campuses, that is, the Mbarara and Kihumuro
campuses. The total student population in both
campuses is 4142 students. MUST offers Certifi-
cates, Diplomas, Bachelors and Masters Degrees
and PhD studies in all disciplines. These programs
are offered across six (6) faculties of Medicine, Sci-
ence, Computing and informatics, Business and
Management science, Applied sciences and Tech-
nology, Interdisciplinary studies, and two (2) insti-
tutes of Tropical forest conservation and Maternal
newborn and child health. Kampala International
University (KIU) is a private, not-for-profit institu-
tion based in Uganda. It was established in 2001
and assumed chattered status in 2009. The Univer-
sity offers a variety of programmes in Health Sci-
ences, Science and Technology, Engineering, Busi-



Prevalence and Factors Associated With Utilization of HIV Self Testing Among Students ofUniversities in South Western Uganda. 3

ness and Education with five faculties (Biomedical
sciences, Clinical medicine, Business and Manage-
ment, Science and and Technology, Education) and
four schools(Allied health, Engineering, nursing sci-
ence and pharmacy). This campus has over 5,000
students. Certificate, diploma, undergraduate, and
postgraduate programs are offered at this campus.
The study population
This study considered students currently en-

rolled at MUST and KIU who were in their respec-
tive formal class WhatsApp groups. Some stu-
dents are classified as medical students if they do
courses offered in medical/health science faculties
and schools whereas others are referred to as non
medical students. The students of these institu-
tions are all adults above 18 years of age the legal
age of an adult in Uganda. The students are of
both gender, and their level of education in each
University is differentiated according to the aca-
demic years of study a student has finished in the
University.
Sample size estimation
Sample size estimation was calculated using a

formula by Keish Lesile (Keish, 1965). We used a
prevalence of 50%, Z value score of 1.96 and con-
fidence interval of 95% was used. The margin of
error was estimated at 0.05. The calculated sample
size was 384 participants.
Sampling and data collection
Due to the country’s lockdown, that found the

student participants not in their respective univer-
sities at the time of data collection, The study used
a purposive sampling method where by any formal
course WhatsApp group that was present at the
time of data collection was targeted. The online
data collection tool was designed and executed us-
ing Google form (via docs.google.com/forms), The
data collection tool was adopted from a similar
study in KwaZulu-Natal province, South Africa [9]
and modified to suit the context of the study site
and units. Student agents in each course offered
at the two universities were identified and assisted
in mapping different course leaders in launching
the Google form link that contained the data collec-
tion tool in their respective formal class WhatsApp
groups using WhatsApp Messenger (Facebook, Inc.,
California, USA 2020) for enrolling potential par-
ticipants. The Google form link was displaying a
consent form to the participant on the first click
that gave a chance to the participant to read and
accept to enter the data collection tool on the sec-

ond click. The tool collected information on socio-
demographics, awareness, practices and utilization
of HIV self testing services in university students.
Data Management
Prior to data entry, data collection tool was

checked for completeness and this was done au-
tomatically by providing a super script star on the
required questions. This ensured that a partici-
pant could not proceed to the next question before
attempting the required question. The control sys-
tem that was receiving responses from participants
was on a recognized and secure email. The system
was removing multiple IP addresses from individu-
als who could have attempted to fill out the survey
form more than once on the same device. Fully
completed questionnaires were extracted from the
Google form to Microsoft Excel 2016 were data
cleaning was done

3 Data analysis
Cleaned data was exported from Microsoft excel to
SPSS IBM version 20 and coded. Descriptive analy-
sis of numeric data was summarized in means with
standard deviations and presented using tables.
Descriptive analysis of categorical data was sum-
marized in frequencies, proportions and presented
using tables. Association between independent
and dependent variables was assessed using Chi
square test (X2) for bivariate analysis in SPSS IBM
version 20.
Ethics considerations
The study protocol was reviewed by the research

ethics committee of Mbarara University of Science
and Technology (MUREC 12/01-20) and the regu-
latory body of research in Uganda (Uganda Na-
tional Council of Science and technology) UNCST
(RESCLEAR/01) approved the continuation of the
study. University clearance was sought from the
Deans of students of the two universities Kam-
pala International University Western Campus and
Mbarara University of Science And Technology.

4 Results
Demographic characteristics of study partici-
pants
Of the 356 participants, the study had 57.3% of

the participants from KIU and 42.7% were from
MUST. 50.3% of participants were male and 40.2%
females with the average at 24.7 (M = 24.7, SD =
3.3), 14.4% of the participants responded to have



4 Namande et al.

a sexual partner and 85.6% had no sexual partner.
49.2% of participants were residing inside the uni-
versity hostels and 50.8% were residing outside the
university hostels. As shown in Table 1 below.
Utilization of HIV self testing among partici-

pants
The study found that university students who

had ever self tested were 43.2%, those who had
never were 56.8%. This captured the prevalence of
HIV Self testing stand at 43.2%, university students
who had ever heard about HIV self testing were
61.8% and those who had never 38.2%, preferred
to test with their partner were 54.8% and not pre-
ferred 45.2%, those who preferred to first get a tele-
phone counseling before self testing were 83.1%
and those who never preferred were 16.6%, HIV
self testing was redone most after three months
with a high response at 54.1%, those of every after
2 months were 23.7%, monthly 18.6% and weekly
1.1%, University student wished to immediately in-
form their partners most after their test turned
positive with a big percentage at 56.1%, those who
wished to inform health workers were 17.7% and
those who wished to inform their parents were
12.9% as shown in table 2 below.
Association of socio-demographics variables

with the utilization of HIV self testing.
Socio demographic variables associated with uti-

lization of HIV self testing were the student’s year
of study (X2=14.111; d.f=4; p=0.007), having a sex-
ual partner (X2=6.319; d.f =1; p=0.012), and place
of residence (X2=15.322; d.f =1; p=0.000). The socio
demographic variables of age and gender where
not significantly associated with utilization of HIV
self test and as shown in table 3 below.
Association of awareness of HIV self testing

with utilization of HIV self testing.
The study found that those who had ever

thought about HIV self test before (x2=8.571;
d.f=1; p=0.003), ever heard about HIV self
testing(x2=139.975; d.f=1; p=0.000), ever seen any
self testing kit(x2=179.145; d.f=1; p=0.000), ever
self tested (x2=216.991; d.f=1; p=0.000), ever read
about HIV self testing (x2=162.312; d.f=1; p=0.000),
knew self testing is done using blood(x2=113.782;
d.f=1; p=0.000), knew that it was done using
mouth fluids(x2=127.431; d.f=1; p=0.000), knew
that HIV self testing can be carried out by a per-
son him/her self (x2=148.986; d.f=1; p=0.000), knew
that the test takes 20-40 minutes (x2=116.182;
d.f=1; p=0.000), test can be negative in less than 3

months(x2=151.59; d.f=1; p=0.000), person needs
to retest after 3 months if the test is negative
(x2=141.668; d.f=1; p=0.000), person needs to
counseled by HIV counselor before taking HIV self
testing(x2=128.485; d.f=1; p=0.000) as shown in the
table 4 below.

5 Discussion
According to the consensus statement from the
first international symposium on HIVST, despite
a lack of data regarding its effect on populations,
HIVST has a vast potential to scale-up access to
HTC services [10]. However, before promoting it
widely, the WHO/UNAIDS meeting highlighted the
need for evidence-based studies on the potential
implementation of HIVST programs in various set-
tings. Our study is a contribution towards this goal
by providing data on the demographic and behav-
ioral factors that are associated with the uptake
of HIVST among students in the South western
Uganda. First, it is important to note that although
the proportion of university students reporting any
form of HIV testing was higher than the specific
use of HIV self testing where the reported levels of
testing were still too low to serve as an effective
HIV prevention tool. Unfortunately, the stigma, dis-
crimination, and violence faced by Ugandans living
with HIV/AIDS contribute to the avoidance of HIV
testing by most people in the country and this is a
similar situation Jamaica [11].
Among the study participants, the results have re-

vealed significant gender differences in HIV testing
utilization among university students in Southwest-
ern Uganda, with males being more in using the
services than females and this was in disagreement
with a study by [12] that showed females mostly
utilized HIV testing services than males. The high
level of HIV self testing utilization among the stu-
dents as revealed in this study could be attributed
to availability of health education programmes to-
wards HIV testing. Over the past decade the gov-
ernment of Uganda through the Uganda AIDS Com-
mission and its development partners increased
public awareness on the causes and preventive of
STIs including HIV/AIDS. This has scaled up the citi-
zens will to utilize HIV testing services to know their
status [4].
Majority of students preferred disclosing their re-

sults to sexual partners than disclosing to parents.
This is because the discussion of parents on sexual



Prevalence and Factors Associated With Utilization of HIV Self Testing Among Students ofUniversities in South Western Uganda. 5

Table 1. Demographic characteristics of University students in selected Universities, southwestern
Uganda.
Characteristics Category Frequency(n) Percent (%)
Gender Male

Female
Prefer not to say

179
143
34

50.3
40.2
9.6

University MUST
KIU

152
204

42.7
57.3

Age group(Years) (24.7 ±
3.3)∗

19-25
26-30
>30

252
73
19

73.5
21
5.5

Year of study Year one
Year two
Year three
Year four
Year five

72
160
103
13
5

20.4
45.5
29.2
3.7
1.4

Have a sexual partner Yes
No

51
302

14.4
85.6

Place of residence Inside the University
Outside the university

175
185

49.2
50.8

% percentage, > greater than, (24.7 ± 3.3)∗Mean and standard deviation of age.

issues with their children are rare in Uganda, due
to the fact that the Ugandan culture is more conser-
vative, religious and traditional beliefs on issues of
sexuality, condom usage and marriage and these
factors are the same as documented by a similar
study in Ghana [13] The factor of willingness to
take the test with a partner can be explained by
a factor HIV self-testing is a novel strategy that is
attractive to both women and men and may prove
better at reaching male partners than many other
current methods. The process of HIVST makes it
a more convenient and independent than other
kinds of HIV Testing and Counseling services and
these phenomena can give a good way to shorten
definitions of couples-HTC. Gender and power rela-
tions will continue to shape the different stages of
decision-making, but the ability to discretely deter-
mine the circumstances and timing upon which a
test is take has been shown to be empowering. This
may enable women to influence domestic decision-
making without provoking negative reactions from
their male partners [14].
Another interesting finding of the study is that

over 61.8% of the students had ever heard about
HIV self testing, but only 43.2% had ever self tested
for HIV. The previous study’s results are in agree-
ment with the above finding [15] which showed that
a number of university students had not had an HIV

test. The unwillingness of students to take HIV test
could be attributed to fear, anxiety and stigma as
well as discrimination associated with AIDS. Fear of
stigma have been shown to influence young adults
to become less likely to engage in preventive be-
haviours [16]and an increase in awareness about
HIV does not predict behavioral change [17]. The
fact that over 85.6% of the participants were not
having sexual partners raises a lot of health con-
cerns as only 54.8% preferred to have HIV test with
their sexual partners. Previous research indicates
that encouraging individuals to be tested if they
engage in at-risk activities will not be appropriate
or effective for individuals who have no perception
of risk [18].
What may be more interesting and informative

for developing and implementing programs pro-
moting voluntary HIV testing is the finding that per-
sons had been aware about HIV testing were more
likely to have had an HIV test. These findings are
not surprising; previous research has found that
persons who have higher levels of HIV knowledge
and awareness are more likely to seek HIV testing
[19]. The high HIVST acceptability has also been
illustrated in different population groups in other
studies in Sub-Saharan countries [20]. It is possible
that with the roll-out of a HIVST program, the fre-
quency of HIV testing among students could there-



6 Namande et al.

Table 2. Utilization of HIV self testing among University students
Characteristic Category Frequency Percent
Ever thought about HIV
testing before

Yes
No

258
13

95.2
4.8

Ever utilized any HIV test-
ing service

Yes
No

329
13

92.4
7.3

Do you know the results
of your last HIV test

Yes
No

232
21

91.7
8.3

Ever tested for HIV with
your partner

Yes
No

41
43

48.8
51.2

Ever heard about HIV self
testing

Yes
No

220
136

61.8
38.2

Ever self tested for HIV Yes
No

150
197

43.2
56.8

Prefer to self test with
partner

Yes
No

178
147

54.8
45.2

Prefer get telephone
counseling before HIV
self testing

Yes
No

281
57

83.1
16.9

Prefer to self test at
health facility

Yes
No

111
203

35.4
64.6

Seek help from clinic in
case of HIV positive re-
sults

Yes
No

317
23

93.2
6.8

Introducing HIV self test-
ing will mean that every-
one will easily know their
status every year

Yes
No

332
24

93.3
6.7

How often do u self test Weekly
Monthly
After 2months
After 3 months
Others

4
66
84
192
9

1.1
18.6
23.7
54.1
2.5

Prefer keep test kits by
self to test at conve-
nience

Yes
No

330
26

92.7
7.3

Immediate person to in-
form after HIV test is pos-
itive

Parents
Friend
Partner
Counselor
Health care worker
Religious leader
Others

46
12
200
32
63
2
1

12.9
3.4
56.2
9.0
17.7
0.6
0.3

% percentage, > greater than



Prevalence and Factors Associated With Utilization of HIV Self Testing Among Students ofUniversities in South Western Uganda. 7

Table 3. Association of socio-demographic variables with utilization of HIV self testing
Characteristic Category Ever had an HIV self test Chi square

value (X2) d.f P
valueYes No

Age 19-25
26-30
>30

102
37
11

153
36
8

4.402 2 0.111

Gender Male
Female
Prefer not to say

76
58
16

102
79
16

0.665 2 0.718

Year of study Year one
Year two
Year three
Year four
Year five

22
63
53
10
2

47
94
47
3
3

14.111 4 0.007

Have a sexual
partner

Yes
No

29
118

20
117

6.3
19

1 0.012
Place of residence Inside the University

Outside the University
55
95

114
83

15.3
22

1 0.000

Df – Degree of freedom > Greater than

Table 4. Association of awareness of HIV self testing with utilization of HIV self testing
Characteristic Cate-

gory
Ever had an HIV
self test

Chi
square
value X2

d.f P
value

Yes No
Ever thought about HIV testing before Yes

No
131
1

123
11

8.571 1 0.003
Ever utilized any HIV testing service Yes

No
145
4

176
21

8.050 1 0.005
Ever heard about HIV self testing Yes

No
147
3

71
126

139.975 1 0.000
Ever seen any HIV self testing kit Yes

No
142
8

44
153

179.145 1 0.000
Ever read about HIV self testing Yes

No
134
16

40
157

162.312 1 0.000
HIV self testing is done using blood Yes

No
140
10

73
124

113.782 1 0.000
HIV self testing is done using fluid from mouth Yes

No
126
24

45
152

127.431 1 0.000
A person can perform the HIVST on him/herself Yes

No
144
6

61
136

148.986 1 0.000
Takes 20 to 40 minutes to get results from HIV self testing Yes

No
121
29

44
153

116.182 1 0.000
Test can be negative if HIV infection is less than three
months

Yes
No

135
15

46
151

151.59 1 0.000
Person needs to retest after three months if test is
negative

Yes
No

138
12

55
142

141.668 1 0.000



8 Namande et al.

fore increase. At the international symposium on
HIVST [11], a concern was raised that the frequency
of HIVST alone should not be used as a preventive
strategy. The WHO has highlighted the importance
of the message that HIVST does not provide a veri-
fied diagnosis on HIV, but requires further testing.
HIVST should provide understandable procedural
instructions for the use and providing meaningful
interpretation of results, and also how to access the
HIV prevention, care and treatment services [21]. In
terms of confirming positive test results, less than
half of the students reported their intention to con-
firm their HIV positive self-test at a local health care
facility. This result was lower than that found by
[22] in South Africa (75%) and almost equal to that
found by [23] in Kenya (35.5%).
University students preferred to have at least

a telephone counseling session during their HIV
self testing session This could be attributed to lim-
ited access to counseling services an individual can
when he/she decides to use the HIV self testing
model. A number of factors which were associated
with the uptake of HIVST among these students,
such as: the awareness about the test, their will-
ingness to counseling and the willingness to take
the test with a partner are recognized as important
indicators of HIV awareness and prevention [24].

6 Limitations of the study
Even though every effort was made to maintain
the quality of the data, the study has shortfalls that
should be noted when interpreting the results. One
of the limitations of this study was cross-sectional
data; therefore, causal interpretation of the results
cannot be established. Furthermore, it was con-
ducted among only in one private university and
one public university thus the results cannot be
generalized to the entire population of university
students in Uganda due to the relative sample size
and the non-probability sampling technique used.
Restricting non university students of the two uni-
versities from accessing the study Google link was
certainly not controlled in case it was forwarded
and attempted by non students of the two Universi-
ties however this was mitigated by inactivating the
Google link every after thirty minutes it was loaded
in the student whatsapp groups.

7 Conclusion
The study demonstrates low levels of utilization of
HIV self testing among University students in asso-
ciation with a number of factors that include how
they are aware towards HIV self testing, places of
their residence, having a sexual partner. Adapted
communication like pre test counseling from a
counselor appears likely essential to increase the
uptake of HIV self testing among university stu-
dents.
Implication to practice and policy:
University administrators and authorities can ac-

tively help to develop and implement HIV education
and prevention strategies in their campuses.
Effective messages and prevention programs

need to be developed and implemented to pro-
mote universal HIV testing and counseling, espe-
cially among younger, sexually experienced stu-
dents, so that these persons may make informed
sexual decisions with respect to protective sexual
behaviors, including having discussions about safer
sex, inquiring about a potential partner’s HIV sta-
tus, and the adoption of condom use with all sex
partners, especially where HIV status is unknown.

7.1
7.1.1 What is known about this topic

• HIV self-testing (HIVST) is globally accepted as an
important complement to existing HIV counseling
and testing (HCT) approaches;
• The acceptability of HIVST among students and

the population groups with poor uptake of HCT
remain limited in Africa;
• HIVST can be performed accurately and it is

an acceptable and feasible testing approach in a
variety of contexts; including populations at ongo-
ing HIV risk and those who may not otherwise be
tested.

7.1.2 What this study adds
• The proportion of University students in South
Western Ugandan that have ever done HIV self test-
ing
• A majority of students had the will to confirm

the result of a HIVST in a local health care facility,
which reinforces the link between the patients and
the health system;
Future research
Future studies should use a qualitative approach

to explore the possible reasons for not willing and



Prevalence and Factors Associated With Utilization of HIV Self Testing Among Students ofUniversities in South Western Uganda. 9

those willing to test for HIV using HIV self testing,
among students.
Data availability
We have a full data set in Microsoft excel which

can shared on request
Conflict of interest
No conflicts of interest. Submitting author is re-

sponsible for coauthors declaring their interests.
Author contribution
All authors reviewed and approved the final

manuscript.

8 Acknowledgment
Management of Mbarara University of Science and
Technology, Kampala International University, re-
spondents, HEPI TUITAH project

9 Funding source
Research reported in this publication was
supported by the Fogarty International Cen-
ter (U.S. Department of State’s Office of the
U.S. Global AIDS Coordinator and Health Diplo-
macy [S/GAC] and the President’s Emergency Plan
for AIDS Relief [PEPFAR]) of the National Institutes
of Health under Award Number R25TW011210.
The content is solely the responsibility of the
authors and does not necessarily represent the
official views of the National Institutes of Health.

10 References:
1. World Health Organization, 2018. Report on the
first international symposium on self-testing for
HIV; the legal, ethical, gender, human rights and
public health implications of self-testing scale-up.
Meeting report-Geneva, Switzerland 8-9.
2. Anarfi, J. (2000). Universities and HIV/AIDS in

Sub Saharan Africa: A Case Study of the Univer-
sity of Ghana, Legon. Paper prepared for ADEA
Working Group in Higher Education. Accra, Ghana
3. Sadgrove J ’Keeping Up Appearances’: Sex and

Religion amongst University Students in Uganda.
Journal of Religion in AfricaVol. 37, Fasc. 1, AIDS
and Religious Practice in East Africa (2007), pp. 116-
144 (29 pages) https://doi.org/10.1163/157006607
X166618
4. UNAIDS: UNAIDS Report on the global

HIV/AIDS epidemic update. 2010, Geneva,
5. EAC/EALP (2010): HIV Sero-Behavioural Study

in 6 Universities in Uganda, Study Report, Septem-
ber 2010.

6. UNAIDS, 2018. Prevention Gap Report.
Geneva, Switzerland: Joint United Nations Pro-
gramme on HIV/AIDS
7. World Health Organization, 2016. The global

health sector strategy on HIV/AIDS: an interim re-
view of progress.
8. Rooyen Van , Olivia Tulloch , Wanjiru Mukoma

,Tawanda Makusha Lignet Chepuka Lucia C Knight
Roger B Peck Jeanette M Lim Nelly Muturi , Miriam
Taegtmeyer. What are the constraints and opportu-
nities for HIVST scale-up in Africa? Evidence from
Kenya, Malawi and South Africa. Journal of In-
ternational AIDS society. 2015,18(1). https://do
i.org/10.7448/IAS.18.1.19445 PMid:25797344 PM-
Cid:PMC4369555
9. Gumede, S. D., & Sibiya, M. N. (2018). Health

care users’ knowledge, attitudes and perceptions of
HIV self-testing at selected gateway clinics at eThek-
wini district, KwaZulu-Natal province, South Africa.
SAHARA J : journal of Social Aspects of HIV/AIDS
Research Alliance, 15(1), 103-109. https://doi.org
/10.1080/17290376.2018.1517607 https://doi.org/
10.1080/17290376.2018.1517607 PMid:30175655
PMCid:PMC6127809
10. World Health Organization . Report on the

first international symposium on self-testing for
HIV. Geneva: 2013.
11. Carr R: Stigma, coping and gender: a study

of HIV+ Jamaicans. Race Gender Class 2002, 9: 122-
144.
12. Oppong Asante: HIV/AIDS knowledge and

uptake of HIV counselling and testing among un-
dergraduate private university students in Accra,
Ghana. Reproductive Health 2013 10:17. https://
doi.org/10.1186/1742-4755-10-17 PMid:23537116
PMCid:PMC3623656
13. Asante KO, Doku PN: Cultural adap-

tation of the condom use self-efficacy scale
(CUSES) in Ghana. BMC Publ Health. 2010,
10: 227-10.1186/1471-2458-10-227. https://doi.or
g/10.1186/1471-2458-10-227 PMid:20433724 PM-
Cid:PMC2874779
14. Kumwenda M, Munthali A, Phiri M, Mwale

D, Gutteberg T. Factors shaping initial decision-
making to self-test amongst cohabiting couples in
Urban Blantyre, Malawi. AIDS Behav. 2014;18:S396-
S404. https://doi.org/10.1007/s10461-014-0817-9
PMid:24929834 PMCid:PMC4102820
15. Tagoe M, Aggor RA: Knowledge, behaviour,

perceptions and attitudes of university of Ghana
students towards HIV/AIDS: what does behavioural



10 Namande et al.

surveillance survey tell us?. J Health Hum Serv Ad-
min. 2009, 32 (1): 51-84.
16. UNICEF, UNAIDS, WHO: Young People and

HIV/AIDS, Opportunity in Crisis. 2002, Washington:
PSI Research Division,
17. Onah HE, Mbah AU, Chukwuka JC, Ikeme AC:

HIV/AIDS awareness and sexual practices among
undergraduates in Enugu, Nigeria. Niger Postgrad
Med J. 2004, 11 (2): 121-125
18. Jackson LA, Millson P, Calzavara L, et al.: HIV-

positive women living in the metropolitan Toronto
area: their experiences and perceptions related to
HIV testing. The HIV Women’s Study Group. Can J
Public Health 1997, https://doi.org/10.1007/BF034
03852 PMid:9094799 PMCid:PMC6951324
19. Kalichman SC, Simbayi LC: HIV testing atti-

tudes, AIDS stigma, and voluntary HIV counseling
and testing in a black township in Cape Town, South
Africa. Sex Transm Infect 2003, 79: 442-447. https:/
/doi.org/10.1136/sti.79.6.442 PMid:14663117 PM-
Cid:PMC1744787
20. Gaydos CA, et al. The uptake and

accuracy of oral kits for HIV self-testing in
high HIV prevalence setting: a cross-sectional
feasibility study in Blantyre, Malawi. PLoS
Med. 2011;8(10):e1001102. https://doi.org/10.
1371/journal.pmed.1001102 PMid:21990966 PM-
Cid:PMC3186813
21. Kalibala S, Tun W, Muraah W, Cherutich P,

Oweya E, Oluoch P. ’Knowing myself first’: feasibil-
ity of self-testing among health workers in Kenya’.
Nairobi: population council; 2011 https://doi.org/1
0.31899/hiv1.1009
22. Mokgatle MM, Madiba S. High acceptability of

HIV Self-Testing among Technical Vocational Educa-
tion and Training College Students in Gauteng and
North West Province: what are the implications for
the scale up in South Africa? PLoS ONE. 2017 Jan
31;12(1):e0169765. https://doi.org/10.1371/journal.
pone.0169765 PMid:28141858 PMCid:PMC5283675
23. Kurth AE, Cleland CM, Chhun N, Sidle J, Were

E, Naanyu V, et al. Accuracy and acceptability of
oral fluid HIV Self-Testing in a general adult pop-
ulation in Kenya. AIDS Behav. 2016;20(4):870-
879. https://doi.org/10.1007/s10461-015-1213-9
PMid:26438487 PMCid:PMC4799243
24. Schwartländer B, Stover J, Hallett T, Atun R,

Avila C, Gouws E, et al. Towards an improved in-
vestment approach for an effective response to
HIV/AIDS. Lancet. 2011 Jun 11;377(9782):2031-41 h
ttps://doi.org/10.1016/S0140-6736(11)60702-2