- Anonymous STD tests aim to bypass social stigma
- Nigeria has one of the highest rates of HIV infection in the world
- Government, health experts cautiously support self-testing
(CNN)Sexual health tests in Nigeria can be a harrowing ordeal.
In addition to the anxiety of discovering their results, visitors to public clinics must face the stigma around sexual activity that remains prevalent in Nigerian society.
"People stare a lot when you go for testing, especially if you are unmarried," says Vivian*, a cosmetics store manager from Abuja.
"They look at you like you are wayward or naughty."
Many Nigerians escape social judgment by avoiding tests, with deadly consequences. In a country with one the world's highest rates of HIV infection, just 10% of the population has been tested for the disease, according to government statistics.
Prevalence of Hepatitis B, another sexually transmitted killer, is even higher.
But Vivian is one of the first customers of a service that allows Nigerians to avoid choosing between their safety and their reputation.
SlideSafe packages are brightly-colored and give no indication of their contents.
"You could have it in front of your mother and she wouldn't know," quips company founder Florida Uzoaru.
The Lagos-based startup is distributing self-testing kits for HIV, Hepatitis B and Syphilis on a strictly anonymous basis, as well as contraceptives for men and women.
Users can order the packages through the company website for between 2,000 to 7,500 Naira ($5-20), and then perform simple blood tests in their home, receiving the results in 15 minutes.
SlideSafe provides provides a step-by-guide to the process, as well as counseling before and after the test for users who are often nervous.
The major challenge for the company is to earn public trust, says Uzoaru, who has a degree in public health policy and a background at healthcare NGOs.
"People are very sensitive about sexual health and want to know you can be trusted," she says. "Trust comes from people knowing you are reliable, but our customers don't want to tell other people about us because of the stigma."
These are early days for SlideSafe, which has sold around 600 kits in the Lagos area. But Uzoaru has big plans to expand into new cities, to test for more diseases, and to establish a dedicated sexual health clinic.
There is growing support for self-testing as a method of controlling sexually transmitted diseases (STDs) in Nigeria.
The head of the National Agency for the Control of HIV/AIDS (NACA) has given a qualified endorsement of self-tests, with the caveat that the products must be government-approved and used in conjunction with expert counseling.
A survey of policy-makers and stakeholders found a majority in favor of introducing self-tests for HIV.
Medical experts in the field are also supportive.
"The self-test is a wonderful alternative to visiting a healthcare provider," says Dr. Brandon Brown, an epidemiologist at UC Riverside School of Medicine who has studied infectious diseases in Nigeria. Such kits can be particularly useful for high-risk groups who are less likely to visit a public clinic, he adds.
But Brown notes that there are also risks associat