{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T20:35:17Z","timestamp":1774384517003,"version":"3.50.1"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["P30MH062294"],"award-info":[{"award-number":["P30MH062294"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>HIV disproportionately affects African refugee male sex workers (ARMSWs) in Italy, who face individual, structural and systemic barriers to HIV prevention and care services. HIV self-testing (HIVST) offers a promising strategy to improve testing access, yet awareness remains understudied in this population. This study examines HIVST awareness and associated factors among ARMSWs to inform targeted interventions. A mixed-methods sequential exploratory design was employed, combining quantitative surveys (n\u2009=\u2009150) with qualitative interviews (20 in-depth interviews, 2 focus group discussions) among ARMSWs in Italy. Participants were recruited through venue-based and snowball sampling in partnership with a community organization. Quantitative data on HIVST awareness and correlates, including sociodemographic, healthcare access, and sex work characteristics, were analyzed using chi-square tests and logistic regression. Qualitative data from audio-recorded interviews underwent summative content analysis to explore awareness pathways and perceptions. Key findings revealed only 45% of participants were aware of HIVST, with just 47.8% of these having ever used a self-test. Higher education (aOR=1.92, p\u2009=\u20090.022) and prior STI testing (aOR=2.32, p\u2009=\u20090.015) significantly predicted awareness of HIVST. Qualitative data showed two awareness pathways: first-time exposure through the study and prior encounters via clients or community programs. Participants highlighted HIVST\u2019s privacy and convenience as key benefits. Community-based, peer-led approaches, combined with healthcare provider engagement, are essential for increasing HIVST awareness and uptake among ARMSWs. These findings have broader implications for improving HIV testing strategies among hard-to-reach migrant populations across Europe.<\/jats:p>","DOI":"10.1371\/journal.pone.0343441","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T18:34:03Z","timestamp":1771871643000},"page":"e0343441","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["HIV self-testing awareness among African refugee male sex workers in Italy: A mixed-methods study"],"prefix":"10.1371","volume":"21","author":[{"given":"Henry Delali","family":"Dakpui","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1718-0381","authenticated-orcid":true,"given":"Gamji Rabiu","family":"Abu-Ba\u2019are","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mubarik 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