Implementation of different HIV self-testing models with implications for HIV testing services during the COVID-19 pandemic: study protocol for secondary data analysis of the STAR Initiative in South Africa

Abstract

IntroductionHIV self-testing (HIVST) presents a convenient, private approach that removes barriers to providing HIV testing services. The Self-Testing Africa (STAR) Initiative aims to scale up HIVST among priority and undertested populations. HIVST has the potential to help maintain testing services during the social distancing restrictions implemented to prevent the spread of COVID-19. This project evaluates linkage to confirmatory testing and treatment for HIV-positive clients for the STAR South Africa site.Methods and analysisThis secondary data analysis protocol aims to evaluate different HIVST distribution models from a prospective study implemented during November 2017 and December 2020 by Ezintsha, a subdivision of Wits Reproductive Health and HIV Institute. Routinely collected distribution and self-reported HIVST outcomes data will be deidentified and analysed. The main outcomes of interest are linkage to care and treatment among HIVST users who report a reactive HIVST result. Additionally, we plan to determine sociodemographic factors associated with linkage to care and treatment among HIVST users. Descriptive statistics will be used to describe the variables of interest, and modified Poisson regression with robust variance estimation will be performed to identify factors associated with linkage to care and treatment among HIVST users who report a reactive HIVST result. Risk ratios and 95% CIs for the risk ratios will be reported.Ethics and disseminationThe study protocol has been approved by the University of Witwatersrand Human Research Ethics Committee. The dissemination plan for the study findings will include presentations to local and international health authorities, international conferences and publications in open access journals.

HIV testing and linkage to ART following secondary distribution of HIV self‐test kits to male partners of women living with HIV: a pilot randomized control trial in Mpumalanga, South Africa

“…These findings are in line with another study from Malawi that shows index partner HIVST is feasible and acceptable to WLHIV [22]. The majority of women believed that index partner HIVST was acceptable to their male partner, similar to other literature that unanimously report HIVST to be acceptable and desired by men [22,[32][33][34]. Our findings suggest that index partner HIVST may be implemented with fidelity and with little to no harm to WLHIV, even among communities with noncohabiting and possibly more mobile populations.…”

Perceived benefits, challenges, and recommendations for HIV research dissemination and implementation science efforts in Tanzania: Findings from the HIV/AIDS Research Forum brainstorming session

“…The need for D&I forums similar to the HIV/AIDS Research Forum is supported by the positive outcomes from prior but smaller meetings that were organized by TACAIDS to address low HIV services uptake among men. For example, TACAIDS organized smaller D&I meetings to address the challenge of reaching men and these gatherings resulted in the development of the Male Catch-Up Plan [4], which consisted of different EBIs such as HIV self-testing that have since been implemented to reach men with the support of policymakers, implementing partners, and donors in Tanzania and other sub-Sahara African countries [37][38][39].…”

MPrEP+ study protocol: a prospective cohort study assessing the feasibility and acceptability of an HIV pre-exposure prophylaxis (PrEP) strategy for male clients of female sex workers in Kisumu, Kenya

“…Several studies have found HIVST to be acceptable and feasible in Kenya,30–32 including among MC 33 34. The enormous strain on health systems wrought by the ongoing COVID-19 pandemic brought into sharp relief the potential of HIVST to ensure access to essential testing resources outside of clinical settings 35–37. At each study visit, participants are given two HIVST kits for self-testing between study visits.…”

“…33 34 The enormous strain on health systems wrought by the ongoing COVID-19 pandemic brought into sharp relief Open access the potential of HIVST to ensure access to essential testing resources outside of clinical settings. [35][36][37] At each study visit, participants are given two HIVST kits for selftesting between study visits. They receive detailed, interactive training on HIVST with pictorial elements, including instructions in the three study languages to contact study staff immediately in event of a positive test for confirmation as per national guidelines.…”