The Effects of Workplace-Based HIV Self-testing on Uptake of Testing and Linkage to HIV Care or Prevention by Men in Uganda (WISe-Men): Protocol for a Cluster Randomized Trial

Abstract

Background HIV testing uptake remains low among men in sub-Saharan Africa. HIV self-testing (HIVST) at the workplace is a novel approach to increase the availability of, and access to, testing among men. However, both access and linkage to posttest services remain a challenge. Objective The aim of this protocol is to describe a cluster randomized trial (CRT)—Workplace-Based HIV Self-testing Among Men (WISe-Men)—to evaluate the effect of HIVST in workplace settings on the uptake of HIV testing services (HTS) and linkage to treatment and prevention services among men employed in private security services in Uganda. Methods This is a two-arm CRT involving men employed in private security services in two Ugandan districts. The participants in the intervention clusters will undergo workplace-based HIVST using OraQuick test kits. Those in the control clusters will receive routine HTS at their work premises. In addition to HTS, participants in both the intervention and control arms will undergo other tests and assessments, which include blood pressure assessment, blood glucose and BMI measurement, and rapid diagnostic testing for syphilis. The primary outcome is the uptake of HIV testing. The secondary outcomes include HIV status reporting, linkage into HIV care and confirmatory testing following HIVST, initiation of antiretroviral therapy following a confirmatory HIV test, the uptake of voluntary medical male circumcision, consistent condom use, and the uptake of pre-exposure prophylaxis by the most at-risk populations. Results Participant enrollment commenced in February 2020, and the trial is still recruiting study participants. Follow-up for currently enrolled participants is ongoing. Data collection and analysis is expected to be completed in December 2021. Conclusions The WISe-Men trial will provide information regarding whether self-testing at worksites increases the uptake of HIV testing as well as the linkage to care and prevention services at male-dominated workplaces in Uganda. Additionally, the findings will help us propose strategies for improving men’s engagement in HTS and ways to improve linkage to further care following a reactive or nonreactive HIVST result. Trial Registration ClinicalTrials.gov NCT04164433; https://clinicaltrials.gov/ct2/show/NCT04164433 International Registered Report Identifier (IRRID) DERR1-10.2196/25099

Barriers and facilitators to oral PrEP uptake among high-risk men after HIV testing at workplaces in Uganda: a qualitative study

“…The study was an explorative narrative study within the Workplace-Based HIV Self-testing among Men (WISe-Men) clinical trial. The protocol for the trial is presented elsewhere [ 36 ]. This was a two-arm cluster randomized trial (CRT) involving men employed in private security services in Uganda (clinicaltrials.gov registration number NCT04164433).…”

“…Men contribute about 11,000 of the new HIV infections in Uganda and about 10,000 AIDS-related deaths among people above 15 years of age [ 16 ]. A study among men employed in security companies revealed that several of them have multiple sexual partners which may increase their risk of HIV [ 17 ]. Similarly, a study in southern Uganda among key and priority populations reported that PrEP uptake was low and those who were initiated were more likely to discontinue usage [ 18 ].…”

Linkage to care and treatment among men with reactive HIV self-tests after workplace-based testing in Uganda: A qualitative study

“…The descriptive qualitative study was conducted as part of the W orkplace-based H I V Se lf-testing among Men (WISe-Men), Cluster randomized trial (Clinical trials.gov ID NCT04164433) ( 20 ). In the WISe-Men trial, men working in private security services in two Ugandan districts were offered HIV self-testing or standard HIV testing services at their workplaces.…”

Examining the Use of HIV Self-Testing to Support PrEP Delivery: a Systematic Literature Review

“…Third, feasibility and acceptability are multifaceted concepts for which the field of implementation research has yet to establish standard, validated metrics and definitions; thus, we captured diverse assessments for these outcomes in the review. Fourth, the review was limited to HIVST use for PrEP initiation and continuation and did not include the many interventions that have used HIVST to support linkage to PrEP services [39] or facilitate HIV testing among sexual partners [40][41][42] or peers [43]. Fifth, we only included English and peer-reviewed publications, and thus may have missed implementation projects that have used HIVST to support PrEP delivery but have not published these findings.…”