Promoting Partner Testing and Couples Testing through Secondary Distribution of HIV Self-Tests

A Randomized Clinical Trial

Dados Bibliográficos

ID23353773
AutoresStanley H Master (0000-0001-7581-8219, University of North Carolina at Chapel Hill), Kawango Agot (0000-0002-6153-8950, Impact Research and Development Organization), Beatrice Obonyo (1234-5678-0000-0002, Impact Research and Development Organization), Sue Napierala (0000-0003-1146-8154, RTI International), Sue Napierala Mavedzenge, Suzanne Maman (0000-0003-4048-1585, University of North Carolina at Chapel Hill), Harsha Thirumurthy (0000-0002-3308-7603, University of North Carolina at Chapel Hill, autor correspondente)
EditoresAlexander C Tsai (0000-0001-6397-7917)
Ano2016
Volume13
Fascículo11
Páginase1002166
Data de publicação2016-11-08
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoPLoS Medicine (JOURNAL)
Identificadores do periódicoISSN: 1549-1277 • E-ISSN: 1549-1676
EditoraPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pmed.1002166
PMID27824882
OpenAlexW2556949014
IdiomaEN
Citações recebidas64
Referências citadas23

BACKGROUND: Achieving higher rates of partner HIV testing and couples testing among pregnant and postpartum women in sub-Saharan Africa is essential for the success of combination HIV prevention, including the prevention of mother-to-child transmission. We aimed to determine whether providing multiple HIV self-tests to pregnant and postpartum women for secondary distribution is more effective at promoting partner testing and couples testing than conventional strategies based on invitations to clinic-based testing. METHODS AND FINDINGS: We conducted a randomized trial in Kisumu, Kenya, between June 11, 2015, and January 15, 2016. Six hundred antenatal and postpartum women aged 18-39 y were randomized to an HIV self-testing (HIVST) group or a comparison group. Participants in the HIVST group were given two oral-fluid-based HIV test kits, instructed on how to use them, and encouraged to distribute a test kit to their male partner or use both kits for testing as a couple. Participants in the comparison group were given an invitation card for clinic-based HIV testing and encouraged to distribute the card to their male partner, a routine practice in many health clinics. The primary outcome was partner testing within 3 mo of enrollment. Among 570 participants analyzed, partner HIV testing was more likely in the HIVST group (90.8%, 258/284) than the comparison group (51.7%, 148/286; difference = 39.1%, 95% CI 32.4% to 45.8%, p < 0.001). Couples testing was also more likely in the HIVST group than the comparison group (75.4% versus 33.2%, difference = 42.1%, 95% CI 34.7% to 49.6%, p < 0.001). No participants reported intimate partner violence due to HIV testing. This study was limited by self-reported outcomes, a common limitation in many studies involving HIVST due to the private manner in which self-tests are meant to be used. CONCLUSIONS: Provision of multiple HIV self-tests to women seeking antenatal and postpartum care was successful in promoting partner testing and couples testing. This approach warrants further consideration as countries develop HIVST policies and seek new ways to increase awareness of HIV status among men and promote couples testing. TRIAL REGISTRATION: ClinicalTrials.gov NCT02386215.

Randomized controlled trial · Adolescent Sexual and Reproductive Health · HIV Research and Treatment · HIV/AIDS Research and Interventions · Internal Medicine · Medicine