Technological harms
guilt
Three participants reporting harms due to the technology itself were interviewed, two had a false positive and one a false negative result. One of the false positive reports, however, was from a non-trial HIV self-sampling (HIVSS) kit (an HIV test where a person takes a sample and sends it to a laboratory for processing) rather than an HIVST kit and their data were excluded.Both remaining participants’ experience of harm emerged from the test itself and did not have external influences exacerbating the outcome. The participant who reported the false positive HIVST described a difficult series of emotions when reading the result, including guilt and shame. He sought support from his wider social network and attended a clinic for confirmatory testing within 24 hours where support was provided. A rapid test was not conducted in clinic, and the participant waited several days for a result, which was negative. The false positive HIVST undermined the participants’ well-being, leading to the termination of a fledgling relationship.At the time […] …I wanted to be on my own for three months and get the next result. […] I pushed a lot of people away. I didn’t really want to be with anybody or see anybody or be in a relationship. So, I would just keep away [from a man he was dating]. Very much felt isolated for three months until I could get another result which I was happy with. […] After the negative one I wanted a second one just to confirm that. It did affect relationships, like I didn’t really want to be sexual at that time. (Cis man aged 26–35 years. Baseline testing, false positive result)The false negative result had a less clear impact: this man had a negative result from an HIVST, several days later a health condition led to his general practitioner testing him for HIV again, this result was positive. The participant felt angry and frustrated, he attempted to access support via the SELPHI website and a helpline run by a voluntary sector organisation. He found it challenging to access information and the offered support did not meet his needs.I didn’t find it helpful. I just found it like, I suppose it was like a mental health study. So, [HIV support helpline] was, I think it was offering counselling but I didn’t feel I needed counselling. I only felt I needed someone to talk to, not a counsellor. (Cis man aged 26–35 years. Baseline testing, false negative result)Both participants reported low HIVST acceptability following their experiences, were suspicious of the technology and reluctant to endorse self-testing.