|Call||Career Development Fellowship (CDF)|
Peer-led HIV self-testing to improve HIV testing and linkage to HIV care among men in two fishing communities in rural Uganda: a pilot intervention (PEST4MEN)
This project aimed to achieve the following objectives/aims: Primary aims • Compare approaches for peer-leader selection in two different fishing communities in order to identify suitable peer-leader selection approaches for typical fishing communities. • Assess uptake of HIV testing services associated with peer-led HIV self-testing among men living in two high HIV prevalence fishing communities • Assess the effects of a peer-led HIVST model in: (i) identifying previously undiagnosed HIV infections; (ii) improving linkage to appropriate HIV prevention, care and treatment services; and (iii) improving retention in HIV care among linked HIV-positive individuals Secondary aims • Determine if HIV-positive individuals will be willing to disclose their HIV status to their peer-leaders, and if disclosure to a peer-leader improves linkage to HIV care among HIV-positive men • Assess if peer-facilitated, mobile outreaches to the fishing communities can improve linkage to and retention in HIV care among HIV-positive men living in isolated fishing communities with limited access to HIV and other health services.
This is a prospective cohort study that aims to effect of peer-led HIV self-testing on HIV testing uptake, linkage to and retention in HIV care using a mixed-methods approach
|Role||Committee/board||Start Date||End Date|
|Editorial Board Member||BMC Public Health||2019|
|Academic Editor||PLoS ONE||2017||2021|
|Associate Editor||AIDS and Behavior||2010||2021|
|Makerere University, Uganda||PhD|
Human Immuno-deficiency Virus (HIV)
Background: Novel interventions are needed to reach young people and adult men with HIV services given the low HIV testing rates in these population sub-groups. We assessed the feasibility and acceptability of a peer-led oral HIV self-testing (HIVST) intervention in Kasensero, a hyperendemic fishing community (HIV prevalence: 37-41%) in Rakai, Uganda.
Methods: This study was conducted among young people (15-24 years) and adult men (25+ years) between May and August 2019. The study entailed distribution of HIVST kits by trained "peer-leaders," who were selected from existing social networks and trained in HIVST distribution processes. Peer-leaders received up to 10 kits to distribute to eligible social network members (i.e. aged 15-24 years if young people or 25+ years if adult man, not tested in the past 3 months, and HIV-negative or of unknown HIV status at enrolment). The intervention was evaluated against the feasibility benchmark of 70% of peer-leaders distributing up to 70% of the kits that they received; and the acceptability benchmark of >80% of the respondents self-testing for HIV.
Results: Of 298 enrolled into the study at baseline, 56.4% (n = 168) were young people (15-24 years) and 43.6% (n = 130) were adult males (25+ years). Peer-leaders received 298 kits and distributed 296 (99.3%) kits to their social network members. Of the 282 interviewed at follow-up, 98.2% (n = 277) reported that they used the HIVST kits. HIV prevalence was 7.4% (n = 21). Of the 57.1% (n = 12) first-time HIV-positives, 100% sought confirmatory HIV testing and nine of the ten (90%) respondents who were confirmed as HIV-positive were linked to HIV care within 1 week of HIV diagnosis.
Conclusion: Our findings show that a social network-based, peer-led HIVST intervention in a hyperendemic fishing community is highly feasible and acceptable, and achieves high linkage to HIV care among newly diagnosed HIV-positive individuals.
|Joseph KB Matovu||Uganda||Busitema University|