BackgroundHIV-related mHealth interventions have demonstrable efficacy in supporting treatment adherence, although the evidence base for promoting HIV testing is inconclusive. Progress is constrained by a limited understanding of processes used to develop interventions and weak theoretical underpinnings. This paper describes a research project that informed the development of a theory-based mHealth intervention to promote HIV testing amongst city-dwelling African communities in the conditions.MethodsA community-based participatory social marketing design was adopted. Six focus groups (48 participants in total) were undertaken and analysed using a thematic framework approach, guided by constructs from the Health Belief Model. Key themes were incorporated into a set of text messages, which were pre-tested and refined.ResultsThe focus groups identified a relatively low perception of HIV risk, especially amongst men, and a range of social and structural barriers to HIV testing. In terms of self-efficacy around HIV testing, respondents highlighted a need for communities and professionals to work together to build a context of trust through co-location in, and co-involvement of, local communities which would in turn enhance confidence in, and support for, HIV testing activities of health professionals. Findings suggested that messages should: avoid an exclusive focus on HIV, be tailored and personalised, come from a trusted source, allay fears and focus on support and health benefits.ConclusionsHIV remains a stigmatized and de-prioritized issue within African migrant communities in the UK, posing barriers to HIV testing initiatives. A community-based participatory social marketing design can be successfully used to develop a culturally appropriate text messaging HIV intervention. Key challenges involved turning community research recommendations into brief text messages of only 160 characters. The intervention needs to be evaluated in a randomized control trial. Future research should explore the application of the processes and methodologies described in this paper within other communities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3278-4) contains supplementary material, which is available to authorized users.

There is a need to increase access to HIV testing in the UK in male migrant communities. We assessed the uptake and acceptability of a workplace HIV testing intervention aimed at increasing access to testing in non-clinical settings.Methodology: 20 health check events were delivered at 11 UK organisations employing male migrant workers. Intervention included HIV testing, cholesterol, BMI, blood glucose, blood pressure; tailored health advice; take-away resources; optional post-event text reminders about HIV and general health. Mixed-methods evaluation included exit questionnaires (n=771), follow-up text messages (n=465) and qualitative interviews (n=35) to assess event acceptability. Qualitative data were analysed thematically.Findings: Attendees were 776 employees from 50 countries (51% male; 30% migrant workers). 52% of attendees undertook an HIV test (75% were first-time testers). 96% considered HIV testing to be an acceptable element of workplace health checks. 79% reported new health-related knowledge. 60% of attendees opted for follow-up text messaging.26% of text respondents reported independently taking HIV test post-event. High acceptability and uptake of HIV testing was associated with convenience, opportunity taking (through removal of deliberation and intentional test-seeking), and normalisation of HIV testing within a general health check.Originality/Value: This study is the first to demonstrate that opt-in HIV testing can be successfully delivered in the workplace within a multicomponent health check. The workplace is an effective means of increasing access to HIV testing in groups at risk for HIV, including male migrant workers.

Background: In the UK, African communities are a focus of public health efforts to increase uptake of HIV testing. Mobile phone interventions may be an innovative way of reaching migrant groups who are known to face multiple obstacles in accessing mainstream health services. This paper presents findings from a feasibility study that used participatory approaches to investigate the use of a text messaging intervention to encourage HIV testing among migrant African communities. Methods: Participants were recruited in the city of Nottingham by a team of community researchers. They were sent two text messages per week (one on HIV and one on general health) for 12 weeks. Baseline and follow-up questionnaires were completed to measure HIV testing behaviour, HIV related knowledge and attitudes and general health. Participants' views on the intervention were solicited. Results: One hundred and sixty-nine participants were enrolled in the study. Follow up data on HIV testing was obtained for 76 participants (45%) and complete follow up measures were available from 60 participants (36%). Eight reported seeking an HIV test during the study period. There were statistically significant positive changes in attitudes about HIV, and a trend towards increased knowledge about HIV. One third of participants reported improvements in physical activity levels, diet, and stress management following the intervention. The intervention messages and structure were positively evaluated. Conclusions: Well-designed mobile phone messaging proved to be a feasible and acceptable intervention to promote both HIV testing and lifestyle behaviours among African migrant communities in the UK. When co-constructed with communities, they hold considerable promise for overcoming some of the health-related barriers faced by migrant populations in new countries. Future research and service development should focus on exploiting and evaluating this potential in relation to other key health priorities.

We explored employer uptake and perceptions of workplace human immunodeficiency virus (HIV) testing delivered to employees as part of Healthy Hub Roadshow, a multi-component general health check. Intervention included health checks with tailored advice delivered to 776 employees at 20 events hosted by 11 different workplaces (29 approached, 38% employer uptake). Delivery partners were third sector organisations with significant expertise in HIV testing and support. Health checks included optional HIV test (using 4th generation Insti finger prick rapid tests), Body Mass Index (BMI), blood glucose, blood pressure, and cholesterol. Mixed-methods evaluation included post-event online survey and qualitative interviews with participating employers. Declining employers were invited to complete an online feedback survey. Workplace HIV testing was positively received by all participating organisations, although 78% (14/18) of declining organisations did not provide their reasons for non-participation. Factors of importance to employers included the perceived trustworthiness of delivery partners, being able to provide engaging opportunities for employee health, offering HIV testing as part of a wider health check, and having visible top-level managerial support. Concerns about hosting the events were rare and related to having limited budgets for future events, and the potential loss of productivity related to attendance during work time. Employers indicated that they would not actively seek out workplace HIV testing as part of health promotion efforts, but they were highly receptive to its inclusion in workplace health and wellbeing provision by credible external delivery partners. In conclusion, workplaces are an untapped arena for HIV awareness raising and testing in the UK. Employers should be encouraged and supported to offer opt-in HIV testing as part of a wider workplace health and wellbeing provision for employees.

No abstract