STI testing needed to be private and confidential
Collection of samples for STI testing by research staff during quarterly clinic visits for all intervention and SOC participants elicited feelings of shame and embarrassment: “I feel shy getting naked in front of a health worker.” Self‐collection of samples at home provided the privacy desired by TGW but involved a third party (the peer) taking them to the clinic laboratory which could breach confidentiality. TGW preferred that peers pick up and deliver samples while maintaining confidentiality.

Self‐collection was perceived as empowering because it made TGW feel they were in control and did not have to undress for a clinician to collect rectal swab samples.

