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Stigma, privacy concerns, sexual behaviors, and testing history shape willingness to use HIV self-testing among African refugee men engaged in sex work in Italy \u2013 a mixed method study\u2014BGSH-023. 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Participants were informed about the study\u2019s objectives, procedures, potential risks, and benefits. Written informed consent was obtained from participants. For those with limited literacy, the consent form was read aloud to ensure comprehension. To minimize undue influence, participation was voluntary; participants could decline any question or withdraw at any time without penalty, and compensation was not contingent on completing all study components. Given the sensitive nature of the study, safety protocols were integrated throughout data collection. Trained research staff and peer researchers monitored for disclosures of acute risk (e.g., violence, psychological distress, or potential HIV\/STI exposure) and referred participants to appropriate local services, including HIV testing, sexual health care, harm reduction, and psychosocial support, through established community partnerships with Circolo Pink and affiliated organizations. Interviews were conducted in private, community-trusted settings, and participants could pause or withdraw at any time. Confidentiality and data security were strictly maintained. No direct identifiers were collected, and participants were assigned unique study IDs. Data were collected using a secure, encrypted platform (REDCap) and stored on password-protected systems with access restricted to authorized personnel; physical materials were kept in locked cabinets. Contact information for scheduling was managed by community partners and excluded from analytic datasets. Deidentified data were stored on a secure institutional platform (University of Rochester Box), and any temporary identifiers were deleted after data verification. Findings are reported in aggregate form, and qualitative excerpts were fully deidentified.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}