Confidentiality {27}
infection, fainting, bruising, pain
INFECTION
All participants will go through an informed consent process. The study staff will provide information for those who are interested in being tested but not interested in study participation. All potential clients will read or have read to them the consent form. The consent form will be available in both the local language and English, and participants will select which language they prefer to be consented in. Each participant will be given an opportunity to ask questions about study participation. If a participant agrees to participate in the study, the study staff will obtain electronic consent, with paper consents as a backup in case of electronic devices not being available. After consenting to participate, a participant may voluntarily withdraw from the study at any time and can choose not to have his/her responses submitted to the study team. Staff have undergone training on confidentiality, couple counseling, and testing and have substantial experience conducting VCT and home HTC. All staff members sign confidentiality agreements. For pre-screening, risks are associated with loss of confidentiality and finger-stick blood collection, including pain, fainting, and rarely, infection or bruising. The risk of loss of confidentiality is minimized due to participant control over the decision of where and when to test using self-administered kits. HIV self-administered testing has been shown to be highly acceptable in other settings in sub-Saharan Africa. However, as with all HIV testing, psychological distress is a risk for individuals who test positive for HIV. Since self-administered testing may be done alone by the participant, lack of immediate support and interpretation of results may contribute to distress. Pre-screening self-testing kits will include contact details to study staff for post-screening counseling (to return for either in-person or text message/telephonic support). Study staff will be available to provide counseling and referral to minimize psychological distress following self-administered pre-screening.