Evaluating oral HIV self-testing to increase HIV testing uptake among truck drivers in Kenya

Kelvin, Elizabeth A.; Mwai, Eva; Romo, Matthew L.; George, Gavin; Govender, Kaymarlin; Mantell, Joanne E.; Strauss, Michael; Nyaga, Eston; Odhiambo, Jacob

doi:10.23846/tw2206cuny

“…Although Manuscript to be reviewed depression status may have changed over the months between the baseline and follow-up interviews, we would not anticipate the association with sexual risk behavior to also change. It is possible that an HIV diagnosis caused depression during follow-up, but only two participants tested positive [24] and neither of these participants had a PHQ-9 score ≥10. Nevertheless, a longitudinal study is needed to establish the temporal order of events.…”

Section: Discussionmentioning

confidence: 99%

Peer Review #3 of "Depression and sexual risk behavior among long-distance truck drivers at roadside wellness clinics in Kenya (v0.1)"

2019

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Background: Truck drivers in sub-Saharan Africa are at high risk for both mental health disorders and sexually transmitted infections. We sought to determine the prevalence of depression among a sample of long-distance truck drivers seeking services at roadside wellness clinics in Kenya and explore the relationship between depression and sexual risk behavior. Methods: We used data from an interviewer-administered questionnaire from 284 truck drivers in Kenya who participated in a randomized controlled trial evaluating whether offering oral HIV self-testing could increase HIV test uptake. Depression was categorized based on the Patient Health Questionnaire (PHQ-9) score, with a score ≥10 indicative of probable major depressive disorder (MDD). Sexual risk behavior was operationalized as the number of condomless sex partners in the past 6 months. Results: The mean participant age was 36.9 years, 83.0% were married, and 37.0% had a secondary school education or higher. Overall, 24% of participants had probable MDD, and 58.2% reported having one condomless sex partner in the past 6 months, whereas 27.3% reported having had two or more. In a multivariable Poisson regression model adjusted for demographic and other relevant variables, including number of sex partners, MDD was significantly associated with a greater number of condomless sex partners (adjusted prevalence ratio 1.63, 95% confidence interval: 1.25-2.12, p<.001). General self-efficacy significantly mediated the association between MDD and number of condomless sex partners. Conclusions: The high prevalence of depression highlights the need to test the feasibility and acceptability of mental healthcare interventions for this population, possibly integrated with HIV prevention services. Future research is needed to better understand the association between depression and sexual risk behavior, as well as the role of self

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“…only offering the provider-administered blood test) would increase HIV testing rates among truck drivers in Kenya. The methods and results of this trial are described in detail elsewhere [24].…”

Section: Materials and Methods Study Proceduresmentioning

confidence: 99%

Peer Review #2 of "Depression and sexual risk behavior among long-distance truck drivers at roadside wellness clinics in Kenya (v0.3)"

2019

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Background: Truck drivers in sub-Saharan Africa are at high risk for both mental health disorders and sexually transmitted infections. We sought to determine the prevalence of depression among a sample of long-distance truck drivers seeking services at roadside wellness clinics in Kenya and explore the relationship between depression and sexual risk behavior. Methods: We used data from an interviewer-administered questionnaire from 284 truck drivers in Kenya who participated in a randomized controlled trial evaluating whether offering oral HIV self-testing could increase HIV test uptake. Depression was categorized based on the Patient Health Questionnaire (PHQ-9) score, with a score ≥10 indicative of probable major depressive disorder (MDD). Sexual risk behavior was operationalized as the number of condomless sex partners in the past 6 months. Results: The mean participant age was 36.9 years, 83.0% were married, and 37.0% had a secondary school education or higher. Overall, 24% of participants had probable MDD, and 58.2% reported having one condomless sex partner in the past 6 months, whereas 27.3% reported having had two or more. In a multivariable Poisson regression model adjusted for demographic and other relevant variables, including number of sex partners, MDD was significantly associated with a greater number of condomless sex partners (adjusted prevalence ratio 1.63, 95% confidence interval: 1.25-2.12, p<.001). General self-efficacy significantly mediated the association between MDD and number of condomless sex partners. Conclusions: The high prevalence of depression highlights the need to test the feasibility and acceptability of mental healthcare interventions for this population, possibly integrated with HIV prevention services. Future research is needed to better understand the association between depression and sexual risk behavior, as well as the role of self

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A Randomized Controlled Trial to Increase HIV Testing Demand Among Female Sex Workers in Kenya Through Announcing the Availability of HIV Self-testing Via Text Message

Kelvin

¹

,

George

²

,

Mwai³

et al. 2018

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We assessed whether informing female sex workers about the availability of HIV self-testing at clinics in Kenya using text messages would increase HIV testing rates. We selected a sample of 2196 female sex workers registered in an electronic health record system who were irregular HIV testers and randomized them to be sent a text message announcing the availability of (1) HIV self-test kits sent three times (intervention), (2) general HIV testing sent three times (enhanced standard of care [SOC]), or (3) general HIV testing sent one time (traditional SOC). Participants in the intervention arm were significantly more likely to test for HIV during 2-month follow-up compared to those in the enhanced SOC (OR 1.9, p = 0.001). There was no difference in HIV testing between those in the enhanced SOC and the traditional SOC arms. Announcing the availability of HIV self-testing via text message increased HIV testing among this high-risk group.

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Evaluating oral HIV self-testing to increase HIV testing uptake among truck drivers in Kenya

Cited by 5 publications

References 36 publications

Peer Review #3 of "Depression and sexual risk behavior among long-distance truck drivers at roadside wellness clinics in Kenya (v0.1)"

Peer Review #3 of "Depression and sexual risk behavior among long-distance truck drivers at roadside wellness clinics in Kenya (v0.1)"

Peer Review #2 of "Depression and sexual risk behavior among long-distance truck drivers at roadside wellness clinics in Kenya (v0.3)"

A Randomized Controlled Trial to Increase HIV Testing Demand Among Female Sex Workers in Kenya Through Announcing the Availability of HIV Self-testing Via Text Message

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