Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda.
Busitema University Faculty of Health Sciences, Mbale, Uganda.
BMC Public Health. 2021 Apr 12;21(1):708. doi: 10.1186/s12889-021-10804-x.
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.
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.
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.
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.
经过培训的非专业人士在社区中分发艾滋病毒自检试剂盒，使目标人群对艾滋病毒检测服务的接受率有所提高。然而，关于培训后的非专业人员在分发试剂盒时所面临的经验和挑战的数据却很少。
本定性研究于 2019 年 9 月在乌干达拉凯的卡森塞罗渔村进行。我们特意从参与以同伴为基础的艾滋病毒自检干预措施的 34 名同伴领导中选择了 18 名参加干预后的定性评估。主要干预措施包括在社区中确定和培训非专业人员（“同伴领导”），将艾滋病毒自检试剂盒分发给他们社交网络中预先选定的成员。本研究的数据是在干预结束时收集的。数据收集了同伴领导在分发试剂盒方面的经验、在分发过程中遇到的挑战以及对未来如何改进典型渔村同伴领导的艾滋病毒自检的建议。数据是按照主题框架方法进行人工分析的。
在 18 名同伴领导中，有 11 名（61.1%）年龄在 20-24 岁之间，有 13 名（72.2%）接受过中等教育。大多数（n=15）同伴领导报告说，他们发现更容易将试剂盒分发给他们的社交网络成员，其中大多数人在社交网络成员的家中或自己的家中分发试剂盒。艾滋病毒自检试剂盒的分发时间（例如下午）根据同伴领导和社交网络成员之间达成的协议而有所不同。少数同伴领导报告说，他们的一些社交网络成员最初对接受试剂盒犹豫不决，而其他同伴领导则报告说，他们花了“很多时间”向一些不识字的成员解释艾滋病毒自检程序。同伴领导主张对不识字的人进行监督下的艾滋病毒自检，并需要不断跟踪社交网络成员，以检查他们是否接受了艾滋病毒检测。
大多数同伴领导成功地将试剂盒分发给了他们的社交网络成员，只有少数人遇到了挑战。这些发现表明，可以培训非专业人员作为有效的艾滋病毒自检试剂盒分发者，以改善社区中试剂盒的分发。
