Summary of themes, subthemes and illustrative quotes
| Theme | Subtheme | Illustrative quote |
| Barriers to HIV testing | Stigma and discrimination | ‘People might be cursing you(…)every time go and play with girls, outside have many sex with other girls’. (28 years old, never tested, Chinese) ‘If I got this kind of sickness [HIV] I am so old already, might as well I jump down die early better’. (54 years old, never tested, Chinese) |
| Low awareness and knowledge of HIV | ‘I got no sickness(…)I got go for medical check-up every month. Doctor tell me ‘your blood test all okay, nothing to be worry’. (54 years old, never tested, Malay) ‘Vitamin E, fruits and coconut water can help to “cleanse” the body after multiple sex(…)wash such bacteria or virus away’ (39 years old, never tested, Malay) | |
| Low self-perceived risk of having HIV | ‘My body can tell [if I have HIV]. I grew fatter what. Since I have no sickness then can eat right, then urine no pain’. (51 years old, never tested, Chinese) ‘Homosexual – higher chance of getting it[HIV] and second thing, hookers, especially other country hookers, Singapore is still ok’. (39 years old, never tested, Malay) | |
| Perceptions of HIVST | Knowledge and attitude towards HIVST | ‘Clinic, the people there are professional, there are doctors there. If the test is positive at least there is someone who can guide us, comfort us, tell us what are the options’. (51 years old, never tested, Chinese) |
| Perceived benefits of HIVST | ‘A lot of people don’t go and check because they are scared of other people finding out(…)they will all go and buy this(self-testing kit)because nobody knows [that they are testing]. I buy it myself and I test myself’. (26 years old, tested in the past 12 months, Chinese) ‘It’s more accessible for me. I can just drop by if it(self-testing kit)is available at any pharmacy, get it back home, use it, instead of making an appointment, waste my time, have to skip work(…)I can test as and when I want’. (27 years old, tested in the past 12 months, Indian) | |
| Perceived limitations of HIVST | ‘(For those who self-test positive)To revenge and go around and play around so they will spread the disease [HIV] you see’. (44 years old, tested in the past 12 months, Chinese) ‘Last time always take precautionary action. Scared of this, of this. Now it’s not the same anymore. Check(using self-testing kit)and don’t have, then check again, don’t worry, don’t have’. (60 years old, tested in the past 12 months, Chinese) | |
| Enabling factors for an HIVST intervention | Testing modality | ‘I’m more keen to use this kit [BioSure] because it’s a higher percentage of getting it right(…)cause it’s HIV so I wouldn’t want to live in doubt, I’d rather just be sure’. (30 years old, tested in the past 12 months, Javanese) ‘I feel that I must poke my finger, no advantage already. Even is given free I may not want it’. (50 years old, never tested, Chinese) ‘If you feel a little uncomfortable, you’d buy the basic kit [OraQuick] first to test, to see that you’re alright(…)But if I’m really scared that I have an infection, I would go for the blood-based test’. (26 years old, tested in the past 12 months, Chinese) |
| Access and cost | ‘The first important thing is staying anonymous because if I really have this disease [HIV], I wouldn’t want anyone to know it first’. (22 years old, tested >12 months ago, Chinese) ‘If the cost difference was going to be 10 dollars, I might as well just go to a GP(…)having somebody do it [HIV testing] for you as a service, someone who is well-trained, who will give you professional advice’. (31 years old, never tested, Malay) | |
| Information and resources | ‘I would prefer both [written and video instructions], I wouldn’t want to make a mistake and waste my $53(…)I would read what is written on it, see the video and I would know what to do’. (39 years old, never tested, Chinese) | |
| Linkage to care | ‘They know this kind of kit will tell you like 90% that you are having HIV so I don’t think they will stop there, they will confirm go to the next step for they want to know what’s going on, what’s going to happen, how long can they like live and how about their family members’. (41 years old, never tested, Malay) | |
| Advertising HIVST | Advertising platforms | ‘I think having them on the shelves is a reminder [to test]. Have sex, I buy a condom and then next to it is a pregnancy test, sometimes it doesn’t even cross my mind, but I do just gaze over. So similarly, I think the test(self-testing kit)should be there as well(…)I know it’s a scare tactic, but it works’. (31 years old, never tested, Malay) |
| Advertising messages | ‘Test earlier is better because earlier get treatment to suppress HIV disease before it becomes full blown(…)Protect your family because if you got HIV you should do some precaution yourself, you won’t affect your family(…)Then maybe say that HIV is not deadly, it’s not uncurable’. (51 years old, never tested, Chinese) |
HIVST, HIV self-testing.