Socially emergent harms
anxiety, HIV anxiety
EVENT
Four participants reported harms arising from their social contexts. For one, this was a negative impact on a relationship, for three this was pressure to test for HIV when they did not want to.One participant reported a difficult relationship with his partner which was characterised by jealousy and suspicion. His partner’s discovery of his HIVST led to discord and contributed to eventual relationship breakdown. His narrative, however, described the inevitability of the outcome: had the discovery of the kit not provoked breakdown another event would have precipitated it.Pressure or persuasion to test during SELPHI was experienced by three individuals in different circumstances: for one, it came from a friend concerned for his health. For another, pressure came from a partner in response to his own worsening mental health due to HIV anxiety. The final participant described being forced to test in a clinic by the police after being violently sexually assaulted when he would have preferred to use HIVST; his experience was thus not related to HIVST or SELPHI participation.Both individuals pressured to test by those in social networks described ambivalence and anxiety around testing for HIV while also recognising their own unmet testing need. For one, this need was the source of significant stress and negatively impacted their well-being. Although both described significant ambivalence around the experience, they were happy they had tested in retrospect and felt more confident with future testing:It [testing] just seems so much more reachable. I feel comfortable doing it now. And I think, more than anything, it’s put my mind at rest that it is getting easier to be able to be tested for this. (Cis man aged 18–25 years. Baseline testing, pressured to test)For participants pressured to test when they did not want to, HIVST through SELPHI was simply the most accessible test available to them at that time. If HIVST was not available this pressure likely would have led them to test using another modality.