Title : An exploratory qualitative (semi- structured interview) study exploring acceptability of self-sampling (testing) for blood borne viruses in the south-Asian community in the West-Midlands in the UK

Abstract:

Background
Blood borne viruses (BBVs), principally HIV and Hepatitis B&C are a major public health challenge. In the UK, ethnic minority populations face a disproportionate burden of infection. BBVs are now largely treatable once detected, but there are significant missed opportunities to screen for them. The ‘Saving Lives Charity’ has developed an online postal testing self-sampling system for BBVs. This sampling style has been found to be effective in the predominantly white heterosexual and homosexual populations.  The development of targeted testing for BBVs and its acceptability in the south-Asian population in the West-Midlands needs to be understood. This study aimed to explore this community’s perception on BBVs and self-sampling, to aid in influencing potential health promotion responses. 

Methods
This was an exploratory qualitative research study utilising semi-structured interviews for primary data collection. Ten participants who identified as ethnically south-Asian residing in the West Midlands were recruited through convenience sampling. Interviews were transcribed verbatim, and analysis was conducted via the ‘The Framework Method’ using NVivo12 and Microsoft Excel to develop the themes. This study followed the ‘Consolidated Criteria for Reporting Qualitative Research’ (COREQ) guidelines.

Results 
Two of the participants interviewed were women. Four major themes were identified. ‘Community understanding and education on BBVs’, ‘barriers influencing health-seeking’, ‘facilitators influencing health-seeking’ and ‘changing the narrative of BBVs’. A key barrier is the perceived lack of knowledge on BBVs conferring a lack of susceptibility to BBVs. Due to widespread self- testing during COVID-19 there has been a shift in the locus of control towards self-sampling. So, if sufficient awareness is raised about its importance, acceptability will be facilitated and influenced. A potential avenue for this is through utilising a testing champion, a member of the south-Asian community who can raise awareness and support about BBV testing. 

Conclusions
This study identified key barriers and facilitators which were supported in previous published literature, including existing stigmas and limited knowledge. The ‘challenge of overfamiliarity’ with health care professionals requires further exploration. There was clear identification by participants of the need for education on BBVs and a testing champion to influence the acceptability of self-sampling.