A pilot trial of the peer-based distribution of HIV self-test kits among fishermen in Bulisa, Uganda

Augustine T. Choko, Mastula Nanfuka, Josephine Birungi, Geoffrey Taasi, Prossy Kisembo, Stephane Helleringer

Research output: Contribution to journalArticle

Abstract

Background HIV self-testing (HIVST) addresses barriers to HIV diagnosis among men, but current approaches to distributing HIVST kits only reach a subset of the men requiring testing. Methods We conducted a pilot trial of the secondary distribution of HIVST kits through peer networks in fishing communities of Buliisa district (Uganda). We recruited distributors (“seeds”) among male patients of a health facility, and among community members. Seeds were trained in HIVST and asked to distribute up to five kits to their peers (“recruits”). Recruits were referred to the study using a coupon, and asked to return the HIVST kit (used or unused). The accuracy of HIVST was measured against a confirmatory test conducted by a health worker. We conducted audio computer assisted self-interviews to measure the occurrence of adverse events, and evaluate the potential yield of peer-delivered HIVST. We also assessed how seeds and recruits rated their experience with peer-distributed HIVST. Results Nineteen seeds offered an HIVST kit to 116 men, and 95 (81.9%) accepted the offer. No recruit reported coercion, but two seeds experienced hostility from recruits or their family members. The sensitivity of peer-distributed HIVST, as interpreted by recruits, was 100%, and its specificity was 92.8%. Among recruits, 29 had never tested (25.8%), and 42 (44.2%) had tested more than a year ago. Three men living with HIV learned their status through peer-distributed HIVST (yield = 1 new diagnosis per 6.3 seeds). Most recruits (85/88) and seeds (19/19) reported that they would recommend HIVST to their friends and family. All seeds stated that they would accept acting as peer distributors again. Conclusions This novel peer-based distribution model of HIVST is safe, and has high uptake. It could help reduce the gender gap in HIV testing in under-served fishing communities in Uganda and elsewhere.

Original languageEnglish (US)
Article numbere0208191
JournalPLoS One
Volume13
Issue number11
DOIs
StatePublished - Nov 1 2018

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analytical kits
Uganda
peers
fishermen
HIV
Testing
Seed
Seeds
testing
seeds
Health
Coercion
Hostility
Health Facilities
health care workers

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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A pilot trial of the peer-based distribution of HIV self-test kits among fishermen in Bulisa, Uganda. / Choko, Augustine T.; Nanfuka, Mastula; Birungi, Josephine; Taasi, Geoffrey; Kisembo, Prossy; Helleringer, Stephane.

In: PLoS One, Vol. 13, No. 11, e0208191, 01.11.2018.

Research output: Contribution to journalArticle

Choko, Augustine T. ; Nanfuka, Mastula ; Birungi, Josephine ; Taasi, Geoffrey ; Kisembo, Prossy ; Helleringer, Stephane. / A pilot trial of the peer-based distribution of HIV self-test kits among fishermen in Bulisa, Uganda. In: PLoS One. 2018 ; Vol. 13, No. 11.
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abstract = "Background HIV self-testing (HIVST) addresses barriers to HIV diagnosis among men, but current approaches to distributing HIVST kits only reach a subset of the men requiring testing. Methods We conducted a pilot trial of the secondary distribution of HIVST kits through peer networks in fishing communities of Buliisa district (Uganda). We recruited distributors (“seeds”) among male patients of a health facility, and among community members. Seeds were trained in HIVST and asked to distribute up to five kits to their peers (“recruits”). Recruits were referred to the study using a coupon, and asked to return the HIVST kit (used or unused). The accuracy of HIVST was measured against a confirmatory test conducted by a health worker. We conducted audio computer assisted self-interviews to measure the occurrence of adverse events, and evaluate the potential yield of peer-delivered HIVST. We also assessed how seeds and recruits rated their experience with peer-distributed HIVST. Results Nineteen seeds offered an HIVST kit to 116 men, and 95 (81.9{\%}) accepted the offer. No recruit reported coercion, but two seeds experienced hostility from recruits or their family members. The sensitivity of peer-distributed HIVST, as interpreted by recruits, was 100{\%}, and its specificity was 92.8{\%}. Among recruits, 29 had never tested (25.8{\%}), and 42 (44.2{\%}) had tested more than a year ago. Three men living with HIV learned their status through peer-distributed HIVST (yield = 1 new diagnosis per 6.3 seeds). Most recruits (85/88) and seeds (19/19) reported that they would recommend HIVST to their friends and family. All seeds stated that they would accept acting as peer distributors again. Conclusions This novel peer-based distribution model of HIVST is safe, and has high uptake. It could help reduce the gender gap in HIV testing in under-served fishing communities in Uganda and elsewhere.",
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