Peer distribution of HIV self-test kits to men who have sex with men to identify undiagnosed HIV infection in Uganda: A pilot study


Autoři: Stephen Okoboi aff001;  Oucul Lazarus aff003;  Barbara Castelnuovo aff001;  Mastula Nanfuka aff003;  Andrew Kambugu aff001;  Andrew Mujugira aff001;  Rachel King aff004
Působiště autorů: Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda aff001;  Clarke International University, Kampala, Uganda aff002;  The AIDS Support Organization (TASO), Kampala, Uganda aff003;  School of Public Health, Makerere University, Kampala, Uganda aff004;  Department of Global Health, University of California San Francisco, San Francisco, California, United States of America aff005
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227741

Souhrn

Introduction

One-in-three men who have sex with men (MSM) in Uganda have never tested for HIV. Peer-driven HIV testing strategies could increase testing coverage among non-testers. We evaluated the yield of peer distributed HIV self-test kits compared with standard-of-care testing approaches in identifying undiagnosed HIV infection.

Methods

From June to August 2018, we conducted a pilot study of secondary distribution of HIV self-testing (HIVST) through MSM peer networks at The AIDS Support Organization (TASO) centres in Entebbe and Masaka. Peers were trained in HIVST use and basic HIV counselling. Each peer distributed 10 HIVST kits in one wave to MSM who had not tested in the previous six months. Participants who tested positive were linked by peers to HIV care. The primary outcome was the proportion of undiagnosed HIV infections. Data were analysed descriptively.

Results

A total of 297 participants were included in the analysis, of whom 150 received HIVST (intervention). The median age of HIVST recipients was 25 years (interquartile range [IQR], 22–28) compared to 28 years IQR (25–35) for 147 MSM tested using standard-of-care (SOC) strategies. One hundred forty-three MSM (95%) completed HIVST, of which 32% had never tested for HIV. A total of 12 participants were newly diagnosed with HIV infection: 8 in the peer HIVST group and 4 in the SOC group [5.6% vs 2.7%, respectively; P = 0.02]. All participants newly diagnosed with HIV infection received confirmatory HIV testing and were initiated on antiretroviral therapy.

Conclusion

Peer distribution of HIVST through MSM networks is feasible and effective and could diagnose more new HIV infections than SOC approaches. Public health programs should consider scaling up peer-delivered HIVST for MSM.

Klíčová slova:

HIV – HIV diagnosis and management – HIV epidemiology – HIV infections – HIV prevention – Men who have sex with men – Pilot studies – Uganda


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Článek vyšel v časopise

PLOS One


2020 Číslo 1