Michael M Chanda|Katrina F Ortblad|Magdalene Mwale|Steven Chongo|Catherine Kanchele|Nyambe Kamungoma|Andrew Fullem|Caitlin Dunn|Leah G. Barresi|Guy Harling|Till Bärnighausen|Catherine E. Oldenburg
HIV self-testing among female sex workers in Zambia: A cluster randomized controlled trial
Harvard Global Health Institute|John Snow (United States)|John Snow (United States)|Harvard University|Harvard Global Health Institute|University College London|Heidelberg University|Harvard Global Health Institute|Africa Health Research Institute|San Francisco Foundation|University of California, San Francisco
background hiv selftesting hivst may play role addressing gaps hiv testing coverage entry point hiv prevention services conducted cluster randomized trial 2 hivst distribution mechanisms compared standard care among female sex workers fsws zambia methods findings trained peer educators kapiri mposhi chirundu livingstone zambia recruited 6 fsw participants peer educatorfsw groups randomized 1 3 arms 1 delivery direct distribution oral hivst peer educator 2 coupon coupon collection oral hivst health clinicpharmacy 3 standardofcare hiv testing participants 2 hivst arms received 2 kits 1 baseline 1 10 weeks primary outcome selfreported hiv testing past month 1 4month visits hivst replace types hiv testing secondary outcomes included linkage care hivst use hivst arms adverse events participants completed questionnaires 1 4 months following peer educator interventions 965 participants enrolled september 16 october 12 2016 delivery n 316 coupon n 329 standard care n 320 20 never tested hiv overall hiv testing 1 month 949 delivery arm 844 coupon arm 885 standardofcare arm delivery versus standard care risk ratio rr 107 95 ci 099115 p 010 coupon versus standard care rr 095 95 ci 086105 p 029 delivery versus coupon rr 113 95 ci 104122 p 0005 fourmonth rates 841 delivery arm 798 coupon arm 751 standardofcare arm delivery versus standard care rr 111 95 ci 098127 p 011 coupon versus standard care rr 106 95 ci 092122 p 042 delivery versus coupon rr 105 95 ci 094118 p 040 1 month majority hiv tests selftests 884 hiv selftest use higher delivery arm compared coupon arm rr 114 95 ci 105123 p 0001 1 month difference 4 months among participants reporting positive hiv test 1 n 144 4 months n 235 linkage care nonsignificantly lower 2 hivst arms compared standardofcare arm 4 instances intimate partner violence related study participation 3 related hiv selftest use limitations include selfreported nature study outcomes overall high uptake hiv testing conclusions study among fsws zambia found hivst acceptable accessible however hivst may substantially increase hiv cascade progression contexts overall testing linkage already high trial registration clinicaltrialsgov nct02827240