Using a Social Network Strategy to Distribute HIV Self-Test Kits to African American and Latino MSM

Abstract

Findings suggest that a network-based strategy for self-test distribution is a promising intervention to increase testing uptake and reduce undiagnosed infections among AAMSM and LMSM.

Peer distribution of HIV self-test kits to men who have sex with men to identify undiagnosed HIV infection in Uganda: A pilot study

“…To our knowledge, this is one of the first studies in sub-Saharan Africa to evaluate secondary distribution of HIVST by MSM peers to their social and sexual networks. Our findings suggest that distributing HIVST kits through peer networks is feasible, acceptable and could be an effective strategy to increase uptake of HIV testing and linkage to care in a marginalized and stigmatized population with low testing coverage [8][9][10][11][12][13][14][15]. Our results are in agreement with prior studies done among heterosexual fishing communities in Uganda, and MSM in the United Kingdom and United States, in which peer distribution of HIVST had high uptake and acceptability and successfully identified undiagnosed HIV infections [13,18,30,31].…”

“…Community-based HIV self-testing delivered by members of a target community or social group could be more effective in reaching those who may not seek testing in high-stigma contexts [20,32]. This approach builds on prior experiences of peer-driven distribution of HIV prevention tools and referral coupons for HIV testing in key populations, e.g., coupon distribution among MSM in Uganda [8][9][10][11][12].…”

“…A recent bio-behavioral survey of Ugandan MSM found that 35% had never tested for HIV [6]. HIV self-testing (HIVST), in which an individual performs and interprets his/her own HIV test [8][9][10][11][12][13], is an acceptable and innovative approach that could increase knowledge of HIV sero-status among MSM, and is recommended by the World Health Organization and Uganda Ministry of Health [3,[14][15][16][17][18][19][20][21][22]. In addition, HIVST is convenient since individuals can test at any time, in private, without having to present to a clinic during fixed working hours.…”

“…However, few studies have evaluated uptake of HIVST among MSM in sub-Saharan Africa [22,24] Novel, effective strategies are urgently needed to increase coverage of HIV testing services among MSM, and promote linkage to prevention, care and treatment services. Peer distribution of HIVST kits in MSM networks may increase access to HIV testing in Uganda where 33% of MSM had never tested for HIV in 2012 [8,9,12,25]. In a recent pilot intervention at the AIDS Support Organization (TASO) secondary distribution of referral coupons by MSM peers increased uptake of facility-based HIV testing [26].…”

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

“…The primary advantages of network-based strategies include: 1) network members have access to broader networks of MSM who may not access prevention programs or services due to concerns of confidentiality or negative experiences with providers; 2) network members can also access their networks outside clinic hours and in venues often not accessible to traditional outreach workers, overcoming some logistical barriers; and 3) being reached and encouraged to test by peers in their own network whom they trust may alleviate the negative impact of HIV-and gay-related stigma on testing behaviors. In a feasibility study conducted among African American and Latinx MSM in California, it was reported that compared to a local county testing program, the peer-based strategy to distribute HIVST kits through MSM's social and sexual networks was significantly more likely to reach those who have never tested for HIV and those who were previously undiagnosed [20]. The objectives of this study were to examine patterns and correlates of HIVST distribution within Chinese MSM's sexual networks.…”