Sexual network distribution of HIV self-testing kits: Findings from the process evaluation of an intervention for men who have sex with men in China

Xiao, Wenjing; Li, Yan; Li-ping, Chen; Fu, Gengfeng; Huang, Yang; Yang, Cui; Yan, Hongjing; Wei, Chongyi

doi:10.1371/journal.pone.0232094

Cited by 23 publications

(23 citation statements)

References 27 publications

(27 reference statements)

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“…Interventional studies have focused on evaluating the impact of implementation strategies on HIV-ST uptake or on overall HIV testing rates. The most commonly studied strategy was distribution of self-testing kits through community members, volunteers or peers [44,61,67,74,78,85,124,125,140,146,151,159,162,194] or intimate partners (usually female) [28,47,49,68,144,147,152,156,161,165,166]. All except Tun et al [74] used direct distribution of kits to users.…”

Section: Acceptabilitymentioning

confidence: 99%

“…Since there were a variety of implementation strategies used, measures of fidelity also varied per study and depended on intervention type. Studies that used peer or partner distribution measured compliance of peer distributors to instructions [85], proportion receiving intended number of coupons [146], proportion of women or peers actually distributing selftests [44,47,68,125,140,147,156,165,169,171], or proportion doing couple-testing [47,140,156,165,166,169]. Other examples of measures include: (1) number of visits by patients to the electronic platform [157], (2) number who completed testing after request via online platform [87, 160], (3) successful use of the testing support application [211], (4) compliance with recommendation that was HIV-ST conducted upon opening a new pre-exposure prophylaxis bottle [127], (5) proportion of participants receiving phone call reminders [152], (6) number of SMS messages sent to participants [150], (7) reports of video issues during post-testing counselling [58], (8) adherence of counsellors to the protocol [205], and (9) using the kit after taking it home [61].…”

Section: Fidelitymentioning

confidence: 99%

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Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review

et al. 2021

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Introduction HIV self-testing (HIV-ST) is an effective means of improving HIV testing rates. Low- and middle-income countries (LMIC) are taking steps to include HIV-ST into their national HIV/AIDS programs but very few reviews have focused on implementation in LMIC. We performed a scoping review to describe and synthesize existing literature on implementation outcomes of HIV-ST in LMIC. Methods We conducted a systematic search of Medline, Embase, Global Health, Web of Science, and Scopus, supplemented by searches in HIVST.org and other grey literature databases (done 23 September 2020) and included articles if they reported at least one of the following eight implementation outcomes: acceptability, appropriateness, adoption, feasibility, fidelity, cost, penetration, or sustainability. Both quantitative and qualitative results were extracted and synthesized in a narrative manner. Results and discussion Most (75%) of the 206 included articles focused on implementation in Africa. HIV-ST was found to be acceptable and appropriate, perceived to be convenient and better at maintaining confidentiality than standard testing. The lack of counselling and linkage to care, however, was concerning to stakeholders. Peer and online distribution were found to be effective in improving adoption. The high occurrence of user errors was a common feasibility issue reported by studies, although, diagnostic accuracy remained high. HIV-ST was associated with higher program costs but can still be cost-effective if kit prices remain low and HIV detection improves. Implementation fidelity was not always reported and there were very few studies on, penetration, and sustainability. Conclusions Evidence supports the acceptability, appropriateness, and feasibility of HIV-ST in the LMIC context. Costs and user error rates are threats to successful implementation. Future research should address equity through measuring penetration and potential barriers to sustainability including distribution, cost, scale-up, and safety.

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Section: Acceptabilitymentioning

confidence: 99%

Section: Fidelitymentioning

confidence: 99%

Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review

et al. 2021

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“…In our study, FSWs were encouraged to share HIV self-tests within their social network. This distribution strategy had already been shown successfull in studies conducted in different countries 13,46,47,48,49 . In our study, HIVST secondary distribution was well received among FSWs' boyfriends and regular clients.…”

Section: Discussionmentioning

confidence: 95%

HIV Self-Testing Implementation, Distribution and Use Among Female Sex Workers in Cotonou, Benin: A Qualitative Evaluation of Acceptability and Feasibility

Moreau¹,

Kintin²,

Atchekpe³

et al. 2021

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Background In Benin, the burden of HIV is disproportionately high among female sex workers (FSWs). HIV testing and knowledge of status are starting points for HIV treatment and prevention interventions. Despite the importance given to testing services in HIV control, its uptake among FSWs remains suboptimal in Benin. HIV self-testing (HIVST) may be useful for increasing testing rates in FSWs. Methods We conducted a pilot study of the distribution of saliva-based HIVST among FSWs in Cotonou and its surroundings, Benin. The HIVST promotion and distribution model included three complementary strategies: community-based, facility-based and secondary distribution. In this qualitative study, we explored the elements influencing HIVST implementation, distribution and use among FSWs. We assessed HIVST acceptability and feasibility in this population. We conducted 29 semi-structured individual interviews with FSWs. Data were interpreted with a thematic analysis method, using the Theoretical Domains Framework. Results Only two FSWs (6.9%) were aware of HIVST before participating in the study. All participants were interested in using HIVST if available in Benin. Many advantages of HIVST were mentioned, including: autonomy, privacy, accessibility, time saving, and the fact that it is a painless test. Barriers to the use of HIVST included: the fear of unreliability, the lack of psychological support and medical follow-up and the possibility of result dissimulation. Participants thought HIVST was easy to use without assistance. HIVST enabled linkage to care for a few FSWs in denial of their HIV-positive status. No case of suicide or violence associated with HIVST was reported. HIVST secondary distribution within FSWs social network was well received. FSWs’ boyfriends and clients showed interest in using the device. Some FSWs reported using HIVST to practice serosorting or to guide their decisions regarding condom use. Conclusions Our study shows a very high level of acceptability for HIVST among FSWs in Cotonou and its surroundings. Results also demonstrate the feasibility of implementing HIVST distribution in Benin. HIVST should be implemented in Benin quickly and free of charge for all individuals at risk of HIV. HIVST offer should be integrated with comprehensive sexual health and prevention services.

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“…In response, the government of Tanzania developed national HIV prevention strategies, including HIV self-testing, [ 27 ] and launched a national Test and Treat campaign focused on increasing HIV testing among men [ 28 ]. However, in Tanzania as well as elsewhere, the majority of male peer-delivered HIV self-testing studies have been conducted with men who have sex with men [ 18 , 29 – 31 ]. Thus, there is limited evidence on how best to reach heterosexual men with HIV self-testing through male peer-delivered approaches.…”

Section: Introductionmentioning

confidence: 99%

Men’s comfort in distributing or receiving HIV self-test kits from close male social network members in Dar Es Salaam, Tanzania: baseline results from the STEP project

et al. 2021

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Background A variety of strategies have been used to reach men with HIV self-testing services, including social network-based HIV self-test kits distribution. However, few studies have assessed men’s comfort to distribute to or receive HIV self-test kits from close male friends within the same social network. In this study, we assessed men’s comfort to distribute to and/or receive HIV self-test kits from close male friends and associated factors among men who socialize in networks locally referred to as “camps” in Tanzania. Methods Data are from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or “camps” in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. We used the Generalized Estimating Equations (GEE) to assess factors associated with being comfortable to distribute to and/or receive HIV self-test kits from close male members within one’s social network. Results Of 505 participants, 67.9% (n = 342) reported being comfortable to distribute to while 68.2% (n = 344) were comfortable to receive HIV self-test kits from their close male friends. Ever having heard about HIV self-testing (Adjusted Prevalence Ratio (Adj. PR): 1.6; 95% Confidence Interval [CI]: 1.3, 1.9), willingness to self-test for HIV in front of a sexual partner (Adj. PR: 3.0; 95%CI: 1.5, 6.1) and exposure to peer-led HIV self-testing education and promotion (Adj. PR: 1.4; 95%CI: 1.2, 1.7) were significantly associated with being comfortable to distribute HIV self-test kits to close male members within one’s social network. Similar results were observed for being comfortable to receive HIV self-test kits from a close male friend within one’s social network. Conclusions Overall, these findings suggest that distribution of HIV self-test kits through close male friends could improve the proportion of men reached with HIV self-testing services and improve HIV testing rates in this population where uptake remains low. However, additional promotional strategies such as peer-led HIV self-testing education are needed to raise awareness and increase the proportion of men who are comfortable to receive and/or distribute HIV self-testing kits.

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Sexual network distribution of HIV self-testing kits: Findings from the process evaluation of an intervention for men who have sex with men in China

Cited by 23 publications

References 27 publications

Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review

Implementation outcomes of HIV self-testing in low- and middle- income countries: A scoping review

HIV Self-Testing Implementation, Distribution and Use Among Female Sex Workers in Cotonou, Benin: A Qualitative Evaluation of Acceptability and Feasibility

Men’s comfort in distributing or receiving HIV self-test kits from close male social network members in Dar Es Salaam, Tanzania: baseline results from the STEP project

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