Access to Oral Fluid-Based Human Immunodeficiency Virus Self-Tests Increases Testing Among Male Partners of Adolescent Girls in Kenya: A Randomized Controlled Trial

Wango, Gift-Noelle; Chakrabarti, Averi; Bair, Elizabeth F.; Thirumurthy, Harsha; Ochillo, Marylyn; Okumu, Olivia; Oluoch, Lennah; Kemunto, Ezina; Bosire, Risper; Napierala, Sue; Agot, Kawango

doi:10.1016/j.jadohealth.2023.02.031

Cited by 3 publications

(4 citation statements)

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“…Six studies were from high‐income countries, 24 in middle‐income countries and nine in low‐income countries. The included studies were conducted in eight countries from 2010 to 2021, seven in China [ 25 , 26 , 27 , 28 , 29 , 30 , 31 ], six in South Africa [ 32 , 33 , 34 , 35 , 36 , 37 ], six in the United States [ 38 , 39 , 40 , 41 , 42 , 43 ], six in Uganda [ 44 , 45 , 46 , 47 , 48 , 49 ], eight in Kenya [ 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ], three in Malawi [ 58 , 59 , 60 ], two in Vietnam [ 61 , 62 ] and one in Zambia [ 63 ].…”

Section: Resultsmentioning

confidence: 99%

“…We classified the social network distribution strategies into three categories based on the people who distributed the test: peers, partners and peer educators. Overall, 16 studies distributed HIVST kits directly from participants to their sexual partners [ 28 , 31 , 34 , 37 , 45 , 49 , 50 , 51 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]. As for social network strategies, 15 studies recruited index participants and encouraged participants to distribute HIVST kits to people in their social networks (alters) [ 25 , 26 , 27 , 29 , 30 , 33 , 35 , 36 , 38 , 42 , 43 , 46 , 47 , 48 , 52 ].…”

Section: Resultsmentioning

confidence: 99%

“…The meta‐analysis showed a doubling of HIV testing uptake compared with standard of care (SOC), the standard facility‐based testing (RR 2.10, 95% CI 1.42−3.10, I 2 66%). Data from 12 RCTs showed that HIV testing rates were significantly higher when social network interventions were delivered through sexual partners than in the SOC (RR 1.90, 95% CI 1.46−2.48, I 2 99%) [ 31 , 34 , 45 , 49 – 51 , 55 – 60 ]. Similarly, findings showed that the intervention group that used social influence with the help of peer educators to disseminate acquisition risk information and attempted to change social norms with the help of peer educators (RR 1.18, 95% CI 1.12, 1.25, I 2 48%) had higher uptake of HIV testing than the comparison group (Figure 5 ) [ 39 , 41 , 44 , 63 ].…”

Section: Resultsmentioning

confidence: 99%

“…54−3.39, I 2 52%). Data on HIV reaction rates for partner distribution were obtained from 10 studies [ 31 , 34 , 45 , 49 , 51 , 55 , 56 , 58 – 60 ]. Interventions using partner‐distributed HIVST kits showed a higher likelihood of detecting HIV reactivity in the partners of participants (RR 1.76, 95% CI 1.…”

Section: Resultsmentioning

confidence: 99%

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Social network strategies to distribute HIV self‐testing kits: a global systematic review and network meta‐analysis

Hu,

Jing,

Fan

et al. 2024

J Int AIDS Soc.

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IntroductionSocial network strategies, in which social networks are utilized to influence individuals or communities, are increasingly being used to deliver human immunodeficiency virus (HIV) interventions to key populations. We summarized and critically assessed existing research on the effectiveness of social network strategies in promoting HIV self‐testing (HIVST).MethodsUsing search terms related to social network interventions and HIVST, we searched five databases for trials published between 1st January 2010 and 30th June 2023. Outcomes included uptake of HIV testing, HIV prevalence and linkage to antiretroviral therapy (ART) or HIV care. We used network meta‐analysis to assess the uptake of HIV testing through social network strategies compared with control methods. A pairwise meta‐analysis of studies with a comparison arm that reported outcomes was performed to assess relative risks (RR) and their corresponding 95% confidence intervals (CI).ResultsAmong the 4496 manuscripts identified, 39 studies fulfilled the inclusion criteria, including one quasi‐experimental study, 22 randomized controlled trials and 16 observational studies. Networks HIVST testing was organized by peers (distributed to known peers, 15 studies), partners (distributed to their sexual partners, 16 studies) and peer educators (distributed to unknown peers, 8 studies). Among social networks, simulating the possibilities of ranking position, peer distribution had the highest uptake of HIV testing (84% probability), followed by partner distribution (80% probability) and peer educator distribution (74% probability). Pairwise meta‐analysis showed that peer distribution (RR 2.29, 95% CI 1.54−3.39, 5 studies) and partner distribution (RR 1.76, 95% CI 1.50−2.07, 10 studies) also increased the probability of detecting HIV reactivity during testing within the key population when compared to the control.DiscussionAll of the three social network distribution strategies enhanced the uptake of HIV testing compared to standard facility‐based testing. Linkage to ART or HIV care remained comparable to facility‐based testing across the three HIVST distribution strategies.ConclusionsNetwork‐based HIVST distribution is considered effective in augmenting HIV testing rates and reaching marginalized populations compared to facility‐based testing. These strategies can be integrated with the existing HIV care services, to fill the testing gap among key populations globally.PROSPERO NumberCRD42022361782

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