Barriers to HIV testing uptake among men in sub-Saharan Africa: a scoping review

Abstract

Introduction: HIV testing among men remains low globally and in sub-Saharan Africa (SSA) in particular, when compared with their female counterparts. The aim of this study was to synthesise evidence on barriers to HIV testing among men in SSA using a scoping review method.

Methods: A scoping review was conducted, guided by Arksey and O’Malley’s framework. A search was made in PubMed, American Doctoral Dissertations via EBSCOhost, Union Catalogue of Theses and Dissertations and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC and Google Scholar. The PRISMA (preferred reporting items for systematic reviews and meta-analyses) chart was used to document the review process. The PRISMA extension for scoping reviews – PRISMA-ScR: checklist and explanation – was also used. The mixed method appraisal tool version 2018 was used to determine the methodological quality of the included studies. Thematic analyses were conducted using NVivo version 11.

Results: Key barriers to HIV testing among men in SSA were knowledge of HIV, fear of testing positive for HIV, stigma associated with HIV, healthcare providers’ services, confidentiality, and clinic setting.

Conclusion: Structural and individual factors present barriers to HIV testing uptake among men in SSA. Community and home-based initiatives have the potential to improve the uptake of HIV testing among men in SSA, considering the confidentiality concerns posed by clinic settings.

Keywords: Africa, HIV testing, men, screening, sub-Saharan Africa