title: 'There's no place like home': perceptions of home-based HIV testing in Lesotho.
abstract: HIV testing has the potential to reduce HIV transmission by identifying and counseling individuals with HIV, reducing risk behaviors, linking persons with HIV to care and earlier treatment, and reducing perinatal transmission. In Lesotho, a high HIV prevalence country in which a large proportion of the population has never tested for HIV, home-based testing (HBT) may be an important strategy to increase HIV testing. We identified factors influencing acceptability of HIV prevention strategies among a convenience sample of 200 pregnant or post-partum Basotho women and 30 Basotho men. We first conducted cross-sectional surveys, followed by key informant interviews with all 30 men and focus group discussions with a sub-set of 62 women. In total, 82% of women reported positive perceptions of HBT; women and men viewed HBT as a potential way to increase testing among men and saw the home as a comfortable, supportive environment for testing and counseling couples and families together. Potential barriers to HBT uptake included concerns about confidentiality, privacy, coercion to test, conflict within the family and fear of HIV/AIDS-associated stigma. Participants emphasized community mobilization and education as important elements of HBT.
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100. jem57@columbia.edu.
authors.forename: J E
authors.initials: JE
authors.lastname: Mantell
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: A L
authors.initials: AL
authors.lastname: DiCarlo
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: R H
authors.initials: RH
authors.lastname: Remien
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: A
authors.initials: A
authors.lastname: Zerbe
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: D
authors.initials: D
authors.lastname: Morris
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: B
authors.initials: B
authors.lastname: Pitt
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: J P
authors.initials: JP
authors.lastname: Nkonyana
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: E J
authors.initials: EJ
authors.lastname: Abrams
authors.affiliation: Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute & Columbia University, 1051 Riverside Dr., Unit 15, New York, NY 10032, USA, Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, New York, NY 10032, USA, ICAP, Columbia University, Mailman School of Public Health, New York, NY 10032, USA and Department of Disease Control, Lesotho Ministry of Health, Maseru, Lesotho 100.
authors.forename: W
authors.initials: W
authors.lastname: El-Sadr
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D007927:Lesotho / Q000453:epidemiology; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011247:Pregnancy; D012648:Self Care / Q000379:methods* / Q000523:psychology