Matovu Joseph Kb, Namwama Aisha Twahiri, Kemigisha Linda, Taasi Geoffrey, Nakabugo Jennipher, Wandabwa Julius, Bogart Laura M, Fakier Nuraan, Wanyenze Rhoda K, Olupot-Olupot Peter, Musinguzi Joshua, Serwadda David
Faculty of Health Sciences, Busitema University, Mbale, Uganda.
Makerere University School of Public Health, Kampala, Uganda.
Arch Public Health. 2025 Jan 24;83(1):23. doi: 10.1186/s13690-025-01511-9.
Social network-based interventions can improve uptake of health interventions. However, limited evidence exists on their feasibility and acceptability in fishing community settings. We assessed the feasibility, acceptability and preliminary effects of a social network-based, peer-led HIV self-testing (HIVST) intervention among men in Uganda.
The PEer-led HIVST intervention for MEN (PEST4MEN) is a pilot intervention conducted among men in Kalangala and Buvuma districts. Baseline data were collected in July 2022 and follow-up data in September 2022. The intervention was implemented through 22 trained lay men ("peer-leaders") who received training in HIVST use and distribution processes and requested to refer at least 20 male members from their social networks for study eligibility screening. To be eligible, men had to be aged 15 years or older with unknown or HIV-negative status. After the baseline interview, men were requested to pick two oral fluid-based HIVST kits from their peer-leaders. The intervention was deemed feasible if peer-leaders gave-out > 80% of the kits and acceptable if > 80% of the kits' recipients used them to self-test for HIV. At the follow-up interview, newly diagnosed HIV-positive men were asked if they had linked to HIV care. Data were descriptively analyzed using STATA version 16.0.
Of 475 screened men, 400 (84.2%) met the eligibility criteria and completed the baseline interview. Of these, 56.7% (n = 227) were engaged in fishing or fishing-related activities. At follow-up, 361 men (90.2%) were interviewed; 98.3% (n = 355) received at least one kit from their peer-leaders. Nearly all (99.1%, n = 352) kits' recipients used them to self-test for HIV. Of the 352 HIV self-testers, 51 men (14.5%) had reactive (positive) HIV self-test results. Nearly one-third of the HIV self-tested men (31.4%, n = 16) were first-time HIV-positive testers. Of these, 87.5% (n = 14) went for confirmatory HIV testing, 50.0% (n = 7) were confirmed as HIV-positive and 71.4% (n = 5) were linked to HIV care.
Our peer-led HIVST intervention was feasible and acceptable and identified newly diagnosed HIV-positive men who were linked to HIV care. However, while these results are promising, we recommend additional research in a randomized controlled trial prior to the eventual roll-out of this intervention.
ClinicalTrials.Gov: NCT05685498 (retrospectively registered on January 17, 2023).
基于社交网络的干预措施可提高健康干预措施的接受程度。然而，关于其在渔业社区环境中的可行性和可接受性的证据有限。我们评估了乌干达男性中基于社交网络、由同伴主导的艾滋病毒自我检测（HIVST）干预措施的可行性、可接受性和初步效果。
男性同伴主导的HIVST干预措施（PEST4MEN）是在卡兰加拉区和布武马区的男性中进行的一项试点干预措施。2022年7月收集基线数据，2022年9月收集随访数据。该干预措施通过22名经过培训的外行人（“同伴领袖”）实施，他们接受了HIVST使用和分发流程的培训，并被要求从其社交网络中推荐至少20名男性成员进行研究资格筛查。符合条件的男性年龄必须在15岁及以上，HIV状态未知或为阴性。在基线访谈后，要求男性从其同伴领袖处领取两份基于口腔液的HIVST检测试剂盒。如果同伴领袖发放了超过80%的试剂盒，则认为该干预措施可行；如果超过80%的试剂盒接受者使用它们进行HIV自我检测，则认为该干预措施可接受。在随访访谈中，询问新诊断为HIV阳性的男性是否已与HIV护理机构建立联系。使用STATA 16.0对数据进行描述性分析。
在475名接受筛查的男性中，400名（84.2%）符合资格标准并完成了基线访谈。其中，56.7%（n = 227）从事渔业或与渔业相关的活动。在随访时，对361名男性（90.2%）进行了访谈；98.3%（n = 355）从其同伴领袖处收到了至少一份试剂盒。几乎所有（99.1%，n = 352）试剂盒接受者都使用它们进行了HIV自我检测。在352名HIV自我检测者中，51名男性（14.5%）的HIV自我检测结果呈反应性（阳性）。近三分之一的HIV自我检测男性（31.4%，n = 16）是首次HIV阳性检测者。其中，87.5%（n = 14）进行了HIV确认检测，50.0%（n = 7）被确认为HIV阳性，71.4%（n = 5）与HIV护理机构建立了联系。
我们由同伴主导的HIVST干预措施是可行且可接受的，并识别出了与HIV护理机构建立联系的新诊断为HIV阳性的男性。然而，尽管这些结果很有前景，但我们建议在最终推广该干预措施之前，在随机对照试验中进行更多研究。
ClinicalTrials.Gov：NCT05685498（于2023年1月17日追溯注册）。
