Men’s Comfort to Distribute or Receive HIV Self-Test Kits from Close Male Social Network Members in Tanzania: Baseline Results from the STEP Project

Matovu, Joseph K. B.; Mbita, Gaspar; Hamilton, Akeen; Mhando, Frank; Sims, Wynton; Thompson, Noah; Komba, Albert; Lija, Jackson; Zhang, Jiajia; Akker, Thomas van den; Duncan, Dustin T.; Choko, Augustine; Conserve, Donaldson F.

doi:10.21203/rs.3.rs-414141/v1

Cited by 3 publications

(3 citation statements)

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“…Similar social network-based strategies for HIVST promotion and distribution have been reported with success in other parts of Tanzania and other countries ( 21 – 24 ). The Ministry of Health in Tanzania, in collaboration with implementing partners such as FHI 360, has also adopted a social and sexual network-based approach during the scale up of HIV self-testing, which was also shown to be acceptable from the formative baseline research phases of the STEP project ( 15 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

Peer-based Promotion and Nurse-led Distribution of HIV Self-Testing Among Networks of Men in Dar es Salaam, Tanzania: Development and Feasibility Results of the STEP Intervention

Conserve,

Abu-Ba’are,

Janson

et al. 2023

Preprint

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Background: According to the 2016-2017 Tanzania HIV Impact Survey, only 45% of men living with HIV (MLWH) were aware of their HIV status. In an effort to increase HIV testing in Tanzania, including among men, the Government of Tanzania passed a law in December 2019 to allowing HIV self-testing (HIVST) to be included in the national testing strategies. The objective of this paper is to describe the development and pilot feasibility assessment of the Self-Testing Education and Promotion (STEP) intervention, which was one of the projects conducted in Tanzania focusing on men to inform policy change. Methods: The development and piloting processes were guided by the ADAPT-ITT model and informed by a national PEPFAR/USAID-funded HIV implementation science project called Sauti. The adapted STEP intervention included the following two components: 1) peer-based HIVST promotion; and 2) nurse-led HIVST distribution. For the feasibility assessment, 25 men were selected and trained to promote HIVST among their peers before helping to recruit 253 men to receive instructions and collect an HIVST kit from a nurse at a community-based study tent site. Results: Of the 236 participants who completed the 1-month follow-up survey, 98.3% reported using the kit. The majority (92.4%) of participants reported a negative HIVST result while 4.2% (n=10) received a positive result. Most (70%, n=7) of the participants with a positive result sought follow-up services at a healthcare facility while 40.3% (n=95) of the participants with a negative self-test result visited the community-based project site. Most of the men (53%, n =129) did not visit a healthcare facility or the study site. The majority of participants reported having a mobile phone and forty-seven of them called someone to share their results while twenty-seven sent a text message about their results. Conclusion: The findings demonstrate that the combined peer-based promotion and nurse-led distribution of HIVST intervention in the community for men was acceptable and feasible. However, the high proportion of men who visited the tent site in the community after self-testing indicated that future research should evaluate the potential for nurses to provide community-based linkage to HIV care and prevention services for self-testers.

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Section: Discussionmentioning

confidence: 99%

Peer-based Promotion and Nurse-led Distribution of HIV Self-Testing Among Networks of Men in Dar es Salaam, Tanzania: Development and Feasibility Results of the STEP Intervention

Conserve,

Abu-Ba’are,

Janson

et al. 2023

Preprint

Self Cite

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“…The STEP project was conducted from 2018 in Dar es Salaam (the commercial capital of Tanzania and the city with the second-highest HIV prevalence) among heterosexual men aged 18 years and older (19). Participants of the STEP project were recruited from 18 camps (social networks comprising mainly young men) in the Manzese and Tandale wards of Dar es Salam, Tanzania (20). Participants were recruited in June 2019 with the following inclusion criteria: (1) male, (2) aged 18 years or older, (3) been a camp member for at least three months, and (4) self-report as HIV-negative at enrollment (21).…”

Section: Methodsmentioning

confidence: 99%

Men’s Willingness to Receive Text Messages and Talk with an HIV counselor from the National HIV Hotline in Tanzania for Support with Linkage to Care Following HIV self-testing

Mhando,

Olughu,

Nyankomo

et al. 2024

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BackgroundTanzania faces a significant burden of HIV, with particular challenges in reaching men and ensuring timely linkage to care. To address these issues, HIV self-testing (HIVST) has been implemented to increase HIV testing and the National HIV Hotlines are being considered as a strategy to facilitate linkage to care. This study aimed to assess the willingness of Tanzanian men to receive support from use the National HIV Hotline via mobile phones for HIVST and linkage to care.MethodsData from 505 men from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or “camps” in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. Logistic regression models were used to assess factors associated with men’s comfort with talking with an HIV counselor over the phone.ResultsThere were 505 heterosexual male participants enrolled in the study with an average age of 29 years. Logistic regression demonstrated that comfortability texting a friend about HIV self-testing (OR =3.37, 95% CI [1.97 – 5.76], being comfortable texting a friend about HIV (OR = 3.84, 95% CI [2.20 – 6.72], previous history of receiving HIV related text messages (aOR = 0.55, 95% CI [0.31 – 0.99] were significantly associated with men’s s comfortability talking to a HIV counselor on the National HIV Hotline following HIVST. The factors such as participants’ comfortability texting friend about HIVST (OR = 2.52, 95% CI [1.49 – 4.25]) and comfortability texting friend about HIV (OR = 2.96, 95% CI [1.83 – 4.80] were significantly associated with the probability of participant’s comfortability receiving text message from HIV counselor following HIVST.ConclusionThese findings suggest an effort to develop and implement a user-friendly digital health intervention that promote comfortability, address private concerns, and deliver tailored support and information to individuals following HIV self-testing.

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“…These models are described in several global guideline documents relevant to key populations [24][25][26][27]. Frequently, DSD models for key populations involve peers, often as educators, counsellors, mobilizers, navigators or simply as network members to leverage expert community knowledge, build trust and increase the uptake of community-based services [28][29][30][31]. For example, sites run by key populations, such as drop-in centres (DICs) and community clinics, provide important treatment alternatives.…”

Section: Dsd Models Tailored To the Needs Of Key Populationsmentioning

confidence: 99%

Adequate funding of comprehensive community‐based programs for key populations needed now more than ever to reach and sustain HIV targets

et al. 2022

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Introduction Globally, over half of the estimated new HIV infections now occur among key populations, including men who have sex with men, sex workers, people who inject drugs, transgender individuals, and people in prisons and other closed settings, and their sexual partners. Reaching epidemic control will, for many countries, increasingly require intensified programming and targeted resource allocation to meet the needs of key populations and their sexual partners. However, insufficient funding, both in terms of overall amounts and the way the funding is spent, contributes to the systematic marginalization of key populations from needed HIV services. Discussion The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recently highlighted the urgent need to take action to end inequalities, including those faced by key populations, which have only been exacerbated by the COVID‐19 pandemic. To address these inequalities and improve health outcomes, key population programs must expand the use of a trusted access platform, scale up differentiated service delivery models tailored to the needs of key populations, rollout structural interventions and ensure service integration. These critical program elements are often considered “extras,” not necessities, and consequently costing studies of key population programs systematically underestimate the total and unitary costs of services for key populations. Findings from a recent costing study from the LINKAGES project suggest that adequate funding for these four program elements can yield benefits in program performance. Despite this and other evidence, the lack of data on the true costs of these elements and the costs of failing to provide them prevents sufficient investment in these critical elements. Conclusions As nations strive to reach the 2030 UNAIDS goals, donors, governments and implementers should reconsider the true, but often hidden costs in future healthcare dollars and in lives if they fail to invest in the community‐based and community‐driven key population programs that address structural inequities. Supporting these efforts contributes to closing the remaining gaps in the 95‐95‐95 goals. The financial and opportunity cost of perpetuating inequities and missing those who must be reached in the last mile of HIV epidemic control must be considered.

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Men’s Comfort to Distribute or Receive HIV Self-Test Kits from Close Male Social Network Members in Tanzania: Baseline Results from the STEP Project

Cited by 3 publications

References 30 publications

Peer-based Promotion and Nurse-led Distribution of HIV Self-Testing Among Networks of Men in Dar es Salaam, Tanzania: Development and Feasibility Results of the STEP Intervention

Peer-based Promotion and Nurse-led Distribution of HIV Self-Testing Among Networks of Men in Dar es Salaam, Tanzania: Development and Feasibility Results of the STEP Intervention

Men’s Willingness to Receive Text Messages and Talk with an HIV counselor from the National HIV Hotline in Tanzania for Support with Linkage to Care Following HIV self-testing

Adequate funding of comprehensive community‐based programs for key populations needed now more than ever to reach and sustain HIV targets

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