Abstract:
BACKGROUND: The COVID-19 pandemic heavily impacted many low- and middle-income countries, such as Peru, overwhelming their health systems. Rapid antigen-detection self-tests for SARS-CoV-2, the virus that causes COVID-19, have been proposed as a portable, safe, affordable, and easy-to-perform approach to improve early detection and surveillance of SARS-CoV-2 in resource-constrained populations where there are gaps in access to healthcare. OBJECTIVE: In 2021, a qualitative study was conducted in two areas of Peru (urban Lima and rural Valle del Mantaro), which aimed to explore decision-makers' values and attitudes around SARS-CoV-2 self-testing. METHODS: Purposive sampling was used to identify representatives of various civil society communities, healthcare workers, and potential implementers, to act as informants whose voices would provide a proxy for the public's attitudes around self-testing. The study received ethics approval from the Universidad Peruana Cayetano Heredia, Peru. RESULTS: In total, 30 informants participated in individual, semi-structured interviews, and 29 informants participated in five focus group discussions. Self-tests were considered to represent an approach to increase access to testing that both the rural and urban public in Peru would accept. The public would prefer saliva-based self-tests and would prefer to access them in their community pharmacies. Information about how to perform a self-test should be clear for each population subgroup in Peru. The tests should be of high quality and low cost. Health-informed communication strategies must accompany any introduction of self-testing. CONCLUSIONS: In Peru, decision-makers consider that the public would be willing to accept SARS-CoV-2 self-tests if they were accurate, safe to use, easily available, and affordable. Adequate information about the self-tests' features and instructions, as well as about post-use access to counseling and care, must be made available through the Ministry of Health in Peru.