Feasibility and acceptability of a pilot, peer-led HIV self-testing intervention in a hyperendemic fishing community in rural Uganda

Matovu, Joseph K. B.; Bogart, Laura M.; Nakabugo, Jennifer; Kagaayi, Joseph; Serwadda, David; Wanyenze, Rhoda K.; Ko, Albert I.; Kurth, Ann

doi:10.1371/journal.pone.0236141

Cited by 22 publications

(34 citation statements)

References 35 publications

(51 reference statements)

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“…Forty-six percent of male and 15% female respondents reported MSP; a high number of these partners were described as “new” partners (37%) [ 35 ]. In a recent study by Matovu et al, 43.7% of young men (20–24 years) and 34% of young women reported three or more sexual partners in the past three months [ 56 ]. Ngabirano et al found 42% and 33.4% sexually active adolescent (13–19 years) males and females reported at least three lifetime sexual partners [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…This is in contrast to the high prevalence of HIV testing in both HIV-positive (89.5%; n = 136) and HIV-negative youth (92%; n = 435) aged 15–24 years old as documented by Mafigiri et al [ 38 ]. The proportion of individuals that have been tested and have received their HIV test results also varied across studies; 96% in a study by the IOM [ 32 ], 92% in Matovu et al [ 56 ], and 54.4% in a study by Opio et al [ 18 ]. A recent study that compared home-based HIV testing and outreach event-based testing among 1,364 fisherfolk residents in Lake Victoria found that although home-based HIV testing uncovered a higher number of new HIV cases, it was associated with lower linkage to care compared to event-based testing [ 70 ].…”

Section: Resultsmentioning

confidence: 99%

“…Another study found that peer-based distribution of HIV self-test kits was a promising HIV testing model associated with high uptake among fishermen in Bulisa, Uganda [ 71 ]. The use of a peer-led HIV self-testing model to improve HIV testing and linkage to HIV care has also been shown to improve HIV testing uptake and linkage to HIV care among 298 young people (15–24 years) and adult men (25+ years) in the Kasensero fishing community in Rakai [ 56 ]. Of the 21 individuals that tested HIV-positive, 57% (n = 12) were first-time testers.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 21 individuals that tested HIV-positive, 57% (n = 12) were first-time testers. After confirmatory HIV testing was done, 10 out of 12 self-tested HIV-positive individuals were confirmed as HIV-positive, with 9 out of 10 (90%) confirmed HIV-positive individuals linked to HIV care within the first week of their HIV diagnosis [ 56 ]. In a secondary analysis of the Lake Kyoga fishing community HIV behavioral survey, disclosure of individual HIV results to a partner [AOR = 16; 95% CI = 3.6–67], residence for > 1 < 5 years [AOR = 0.04; 95% CI = 0.005–0.33], and no mobility [AOR = 3.6; 95% CI = 1.1–12] were significantly associated with utilization of couple HIV counseling and testing service [ 72 ].…”

Section: Resultsmentioning

confidence: 99%

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HIV epidemic in fishing communities in Uganda: A scoping review

et al. 2021

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Background Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. In Uganda, literature on HIV in fishing communities has grown extensively since the first country’s documented case of HIV in a fishing community in 1985. The current study describes the status of the HIV burden, prevention, and treatment in Ugandan fishing communities. Method This scoping review was conducted based on the York Framework outlined by Arksey and O’Malley. We searched the PubMed, Embase, and Web of Science databases to identify relevant quantitative and qualitative studies on HIV incidence, HIV prevalence, HIV-related risk factors, HIV testing, antiretroviral therapy coverage and adherence, and interventions to improve treatment outcomes and reduce HIV risk factors. Results & conclusion We identified 52 papers and 2 reports. Thirty-four were quantitative, 17 qualitative, and 3 had a mixed-methods design. Eleven studies reported on the prevalence of HIV and 8 on HIV incidence; 9 studies documented factors associated with HIV incidence or HIV positive status; 10 studies reported on HIV testing coverage and/or associated factors; 7 reported on antiretroviral therapy coverage/adherence/outcomes; and 1 study reported on the impact of combination HIV interventions in fishing communities. This scoping review revealed a significant lack of evidence in terms of what works in HIV prevention and for improving adherence to ART, in contrast to the relatively large amount of evidence from observational quantitative and qualitative studies on HIV prevalence, incidence and related risk factors in Ugandan fishing communities. Intervention studies are urgently needed to fill the current evidence gaps in HIV prevention and ART adherence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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HIV epidemic in fishing communities in Uganda: A scoping review

et al. 2021

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“…This qualitative study was conducted at the end of a large, peer-led HIV self-testing intervention implemented to assess the feasibility and acceptability of a peer-led HIV self-testing intervention in Kasensero fishing community, Rakai, Uganda. The study methods for the main intervention are described elsewhere [ 24 ]. In brief, the intervention entailed identification of lay people (referred to as ‘peer-leaders’ in this paper) in the community who were trained to distribute HIV self-test kits to pre-selected members of their social networks.…”

Section: Methodsmentioning

confidence: 99%

Peer-leaders’ experiences and challenges in distributing HIV self-test kits in a rural fishing community, Rakai, Uganda

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Background Distribution of HIV self-test kits by trained lay people in the community has resulted in increased uptake of HIV testing services among the targeted populations. However, little data exists on the experiences and challenges faced by trained lay people while distributing the kits. Methods This qualitative study was conducted in Kasensero fishing community, Rakai, Uganda, in September 2019. We purposely selected 18 out of 34 peer-leaders that participated in a peer-led HIV self-testing intervention to participate in a post-intervention qualitative evaluation. The main intervention included identification and training of lay people in the community (‘peer-leaders’) to distribute HIV self-test kits to pre-selected members of their social network. Data for this study were collected at the end of the intervention. Data were collected on peer-leaders’ experiences in distributing the kits, challenges experienced during distribution and suggestions on how to improve peer-led HIV self-testing in typical fishing communities in the future. Data were analyzed manually following a thematic framework approach. Results Of the 18 peer-leaders, eleven (61.1%) were aged 20–24 years while thirteen (72.2%) had secondary education. Most (n = 15) of the peer-leaders reported that they found it easier to distribute the kits to their social network members, with most of them distributing the kits at the social network members’ homes or at their own homes. HIV self-test kits were distributed at varying times (e.g. in the afternoon) depending on the agreement reached between the peer-leader and their social network member. A few peer-leaders reported that some of their social network members initially hesitated to accept the kits while other peer-leaders reported that they spent a ‘lot of time’ explaining the HIV self-testing procedures to some of their illiterate members. Peer-leaders argued for supervised HIV self-testing for illiterate people and the need to continuously follow-up social network members to check if they tested for HIV. Conclusion A majority of the peer-leaders successfully distributed the kits to their social network members save for a few who experienced challenges. These findings suggest that lay people can be trained as effective HIV self-test kits distributors to improve the distribution of kits in the community.

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