Search HIVST

Promoting male partner HIV testing and safer sexual decision making through secondary distribution of self-tests by HIV-negative female sex workers and women receiving antenatal and post-partum care in Kenya: a cohort study


Author
Thirumurthy et al.

Publication year
2016

Country

Type of approach
Facility-based

Type of assistance
Directly assisted

Specimen
Oral-fluid

Study population
Mixed: Vulnerable population and key population: women receiving antenatal and post-partum care and female sex workers

Study design
Feasibility/acceptability

Sample size
265

UNAIDS HIV prevalence (2017)
5.9 [4.9 - 7.0]

Methodology
Cohort study among HIV-negative women 18-39 years old who presented at antenatal care or post-partum care settings and female sex workers presenting at drop-in centres were provided HIV self-test kits to deliver to their male partners and social networks. Participants received five self-tests each. Structured interviews were conducted with participants at enrolment and over 3 months to determine how self-tests were used. Outcomes included the number of self-tests distributed by participants, the proportion of participants whose sexual partners used a self-test, couples testing, and sexual behaviour after self-testing. All outcomes were based on self-reporting by women distributing the HIVST kits.

Summary of findings
Participants with primary sexual partners distributed self-tests to partners: 91% of 58 participants in antenatal care (ANC), 86% of 106 in post-partum care (PPC), and 75% of 85 female sex workers (FSW). Couples testing occurred in 27 of 53 (51%) ANC clients, 62 of 91 (68%) PPC clients, and 53 of 64 (83%) FSWs. Among tests received by primary and non-primary sexual partners, 4% of 53 tests from participants in ANC, 2% of 91 in PPC, and 14% of 298 FSWs had positive results. Participants reported sexual intercourse with 235 (62%) of 380 sexual partners who tested HIV-negative, compared with eight (18%) of 45 who tested HIV-positive (p<0001); condoms were used in all eight intercourse events after positive results compared with 104 (44%) after of negative results (p<0018). Four participants reported intimate partner violence as a result of self-test distribution: two in the PPC group and two FSWs. No other adverse events were reported.

Acceptability
n/a

Acceptability details
n/a

Willingness to pay
n/a

Willingness to pay details
n/a

Sensitivity
n/a

Specificity
n/a

Concordance
n/a

HIV positivity
10.1% (45/442) identified partners

Accuracy details
n/a

Social harm
Four participants reported intimate partner violence as a result of self-test distribution: two in the post-partum care group and two female sex workers.

Linkage to prevention, care and treatment
Of the 41 HIV-positive individuals identified by female sex workers participants who did not already know their HIV status, 26 (65%) sought confirmatory testing within the 3-month follow-up period and 23 (58%) were reported to have linked to care.

Source

Study status
Completed