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The impact of HIV self-testing on HIV status disclosure with clients among female sex workers in Kampala, Uganda - A randomized controlled trial


Author
Musoke et al.

Publication year
2017

Country

Type of approach
Dual

Type of assistance
n/a

Specimen
Oral-fluid

Study population
Key population: Key population: female sex workers

Study design
Values and preferences

Sample size
960

UNAIDS HIV prevalence (2017)

Methodology
Three-arm randomized controlled study where groups of one peer educator and eight female sex workers were randomized to either: (1) peer provision of HIVST, (2) facility pick-up of HIVST (exchangeable with a coupon), and (3) standard HIV testing services. Participants in the intervention arm received two HIVSTs/coupons, one after randomization and another three months later. Participants completed a baseline, one-month, and four-month questionnaires. At both follow-up questionnaires participants were asked how often (never, seldom, sometimes, often, always) they ask clients to share their HIV status and how often they shared their HIV status with clients before sex in the past month.

Summary of findings
960 FSWs were enrolled and randomized between October-November 2016. Median age was 28 years (IQR: 24-32) and participants reported a median of 5 clients per night (IQR: 4-7). HIV status disclosure between female sex workers and clients was uncommon. At one- and four-months 70% (n=n/a) and 79% (n=n/a) of participants, respectively, never or seldom asked clients their HIV status before sex; there were no statistically significant differences across study arms (four-month risk ratio - peer vs. standard: 1.06, 95%CI: 0.94-1.20, p0.37; facility vs. standard: 1.05, 95%CI: 0.93-1.29, p0.40; peer vs. facility: 1.01, 95%CI: 0.90-1.13, p0.93). 75% of participants at one-month and 78% of participants at four-months never or seldom told clients their HIV status before sex, again there were no statistically significant difference across study arms (four-month risk ratio- peer vs. standard: 1.00, 95%CI: 0.89-1.13, p0.96; facility vs. standard: 1.02, 95%CI: 0.90-1.15, p0.78; peer vs. facility: 0.99, 95%CI: 0.87-1.12, p0.83).

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
n/a

Accuracy details
n/a

Social harm
n/a

Linkage to prevention, care and treatment
n/a