Acceptability of Covid-19 self-testing among Primary Health Care users

ABSTRACT OBJECTIVE: To identify factors associated with the acceptability of Covid-19 self-testing among socioeconomically vulnerable populations. METHODS: Cross-sectional study using data from the "TQT Covid-19" project, which involved users from 19 primary health care (PHC) units located in socioeconomically vulnerable areas in Salvador (BA) and Rio de Janeiro (RJ), Brazil. Data were collected between July 2022 and July 2023. Descriptive analysis of Covid-19 self-test acceptability was performed, and logistic regression models were used to estimate factors associated with acceptability, with respective 95% confidence intervals (95%CI). RESULTS: Among 7,939 study participants, 45.8% (95%CI 44.75–46.95) reported willingness to use a Covid-19 self-test. In the analysis of associated factors, regarding sociodemographic profile, non-Black individuals (ORa = 1.17; 95%CI 1.02–1.34), cisgender men (ORa = 1.23; 95%CI 1.12–1.37), and participants with higher educational levels (ORa = 1.60; 95%CI 1.43–1.79) were more likely to accept the self-test. Those with prior knowledge of the self-test (ORa = 2.33; 95%CI 2.11–2.58) and those previously diagnosed with Covid-19 (ORa = 1.17; 95%CI 1.05–1.28) also reported higher acceptance. CONCLUSIONS: Provision of Covid-19 self-testing should be considered as a complement to testing within the public health system, especially due to its acceptance among vulnerable populations and the difficulties in accessing testing in many Brazilian regions. During periods of increased Covid-19 incidence, self-testing may serve as an important strategy for mass case detection, provided that access and knowledge are expanded so communities can play an active role in SARS-CoV-2 epidemiological surveillance.