Evaluating the digital dispensation of HIV self-testing (HIVST) among men who have sex with men (MSM) in Pakistan: Seeing through the Consolidated Framework for Implementation Research (CFIR) lens

HIV self-testing (HIVST) has recently been introduced through a digital platform for men who have sex with men (MSM) in Pakistan, where they can order and receive OraQuick HIVST via mail. The current study aimed to evaluate the digital dispensation of HIVST to the MSM community in Pakistan. Semi-structured interviews with MSM who availed HIVST services were conducted through in-depth interviews (IDIs) and focus group discussions (FGDs). Participants were recruited from HIV community-based organizations (CBOs) in Karachi and Lahore. The interviews were coded, and thematic analysis was performed using NVIVO 14.0. Twelve MSM were interviewed in the IDIs, and two FGDs were conducted with a total of 12 MSM. Key emergent themes highlighted that digital dispensation reduces HIV testing barriers and allows peer diffusion of testing services. MSMs can order HIVST digitally to dispense at the place of their choice. This allows them to bypass perceived stigma faced during in-person testing, including in the CBOs. However, MSM still fear stigma at home where HIVST might potentially be delivered. Participants noted difficulty in navigating the digital platform and a lack of comprehensive services including, condoms, lubricants, and counselling. The participants emphasized the importance of demand generation through social media and dating applications. Provision of a comprehensive service delivery package, digital demand generation through social media, and dating applications is recommended for strengthening digital HIVST services.