Palmer Shaun, Dijkstra Maartje, Kigoro Alex, Mohamed Khamisi, Mukuria Nana, Mahmoud Shally, Gichuru Evanson, van der Else Elise M, Sanders Eduard J
Stichting IAVI, Amsterdam, The Netherlands.
Division of Infectious Diseases, Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Center, Academic Medical Center, University of Amsterdam, The Netherlands.
medRxiv. 2025 Apr 10:2025.04.08.25324345. doi: 10.1101/2025.04.08.25324345.
Targeted peer mobilisation can improve access to HIV testing and care and may impact onward HIV transmission. We describe the development and implementation of a peer mobilisation training programme for oral HIV self-testing (OST) and referral for acute HIV infection testing among gay and bisexual men (GBMSM) and transgender women (TGW) in coastal Kenya.
The training programme covered five modules: 1) safe sex, 2) OST, 3) acute HIV infection (AHI), 4) HIV partner notification services, and 5) mobilisation skills. Mobilisers attended two training sessions and weekly meetings between March and June 2019. Mobilisers offered OST to GBMSM and TGW peers and extended an AHI referral card for point-of-care HIV-RNA testing when peers reported AHI symptoms. Two focus group discussions with 18 mobilisers and 15 in-depth interviews with mobilised clients who were newly HIV diagnosed were conducted to assess which components of the training programme were most helpful in mobilising clients for HIV testing.
Mobilisers felt empowered through the training programme, which enhanced their mobilisation skills across two areas: (1) networking skills and (2) client empowerment. Facilitators for HIV testing were confidentiality of the OST, presence of STI symptoms, and building trust between mobilisers and clients. Mobilisers and clients reported challenges as: (1) misconceptions regarding OST and symptoms of AHI, (2) logistical and financial issues, and (3) stigma and security concerns.
Our training programme facilitated peer mobilisers to extend OSTs among GBMSM and TGW in coastal Kenya while it was more difficult to refer clients directly for AHI testing. Mobilisers felt empowered through enhanced mobilisation skills which helped them to mobilise clients for HIV testing. A targeted training programme was helpful in mobilising peers to take up HIV testing.
有针对性的同伴动员可以改善艾滋病毒检测和治疗的可及性，并可能影响艾滋病毒的进一步传播。我们描述了一项针对肯尼亚沿海地区男同性恋者（GBMSM）和跨性别女性（TGW）开展的同伴动员培训计划的制定与实施情况，该计划用于艾滋病毒口腔自我检测（OST）以及急性艾滋病毒感染检测的转诊。
培训计划涵盖五个模块：1）安全性行为，2）OST，3）急性艾滋病毒感染（AHI），4）艾滋病毒性伴通知服务，以及5）动员技巧。动员者在2019年3月至6月期间参加了两次培训课程和每周例会。动员者向GBMSM和TGW同伴提供OST，并在同伴报告有AHI症状时发放用于即时护理艾滋病毒核糖核酸检测的AHI转诊卡。与18名动员者进行了两次焦点小组讨论，并对15名新诊断出感染艾滋病毒的被动员客户进行了深入访谈，以评估培训计划的哪些组成部分对动员客户进行艾滋病毒检测最有帮助。
动员者通过培训计划感到有了力量，这在两个方面增强了他们的动员技巧：（1）社交技巧和（2）增强客户能力。艾滋病毒检测的促进因素包括OST的保密性、性传播感染症状的存在以及动员者与客户之间的信任建立。动员者和客户报告的挑战包括：（1）对OST和AHI症状存在误解，（2）后勤和财务问题，以及（3）耻辱感和安全担忧。
我们的培训计划促进了同伴动员者在肯尼亚沿海地区的GBMSM和TGW中推广OST，而直接将客户转诊进行AHI检测则更加困难。动员者通过增强的动员技巧感到有了力量，这有助于他们动员客户进行艾滋病毒检测。有针对性的培训计划有助于动员同伴进行艾滋病毒检测。
