"When the self-test kit comes with the woman, it will be like she is overpowering you": A qualitative study of men's and women's perspectives on HIV self-testing kits in South Africa.

KwaZulu-Natal (KZN) in South Africa has the highest HIV incidence among women of childbearing age globally. HIV self-testing (HIVST) distribution has the potential to spark partner communication about postpartum HIV prevention and treatment. We conducted two focus group discussions (FGDs) with men and women in Durban, South Africa, to refine an intervention promoting partner HIVST and PrEP uptake among postpartum women without HIV. Participants (ages 18-40) had a child in the past year and were recruited from the community. Transcripts and notes were analysed using content analysis. Median age was 31.5 for men (N=10) and 26 for women (N=10). Four key categories emerged: (1) general attitudes toward HIVST; (2) using a desire to protect the family as motivation for HIVST; (3) the need for emotional support, education and attention to gender norms to ensure successful HIVST uptake and coping with results and (4) gender norms as barriers when women deliver HIVST kits to male partners. Both men and women valued HIVST for its convenience and privacy. However, traditional gender dynamics were seen as barriers to women distributing kits. The findings underscore the need for intervention components that address gender norms, power dynamics, communication skills and community-based HIVST education.