An Ethnographic Study of Peer-Distributed HIV Self-Testing: Acceptability and Feasibility Among University Students in Yaoundé

HIV remains a significant public health challenge in sub-Saharan Africa, with university students being a key demographic for prevention. HIV self-testing (HIVST) is a strategy to increase testing coverage, but its distribution through peer networks in university settings is under-researched. This ethnographic study aimed to explore the acceptability and feasibility of peer-distributed HIV self-testing among university students in Yaoundé, Cameroon. An ethnographic study was conducted over several months. Data collection included participant observation in student social and residential settings, and in-depth interviews with 42 university students who had received an HIVST kit from a trained peer distributor. Field notes and interview transcripts were analysed thematically. Peer distribution was highly acceptable. Students valued the confidentiality, convenience, and non-judgemental approach of peers, with a prominent theme being the reduction of anticipated clinic-based stigma. Regarding feasibility, logistical challenges included discreet kit storage and the initial cost of kits. Approximately three-quarters of interviewed participants reported using the self-test kit. Peer distribution is an acceptable and largely feasible model for delivering HIV self-testing to university students in this setting, as it addresses critical barriers such as stigma and access. Programmes should integrate peer-distributed HIVST into campus health initiatives. Training for peer distributors should include counselling skills and logistical support for kit storage and referral pathways. HIV self-testing, peer distribution, university students, Cameroon, acceptability, feasibility, ethnography This study provides an in-depth, contextual understanding of the social and logistical dimensions of peer-led HIV self-testing distribution in a West African university, informing future implementation strategies.