Development and feasibility of the peer and nurse-led HIV Self-Testing Education and Promotion (STEP) intervention among social networks of men in Dar es Salaam, Tanzania: application of the ADAPT-ITT model

Authors

Donaldson F. Conserve, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, Washington, DC, USA. dxc341@gmail.com.
Gamji Rabiu Abu-Ba'are, School of Nursing, Rochester University, Rochester, NY, USA.
Samuel Janson, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW, Washington, DC, USA.
Frank Mhando, Johannesburg Business School, University of Johannesburg, Johannesburg, SA, South Africa.
Grace V. Munisi, EngenderHealth -Tanzania, Dar es Salaam, Tanzania.
Busara Drezgic, EngenderHealth -Tanzania, Dar es Salaam, Tanzania.
Abubakar Rehani, T-MARC -Tanzania, Dar es Salaam, Tanzania.
Wynton Sims, School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Tiarney D. Ritchwood, School of Medicine, Duke University, Durham, NC, USA.
Augustine T. Choko, Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Stella E. Mushy, Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Cheryl Johnson, Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.
Larissa Jennings Mayo-Wilson, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Albert Komba, Jhpiego Tanzania - An Affiliate of Johns Hopkins University, Dar es Salaam, Tanzania.
Peris Urasa, National AIDS Control Program, Ministry of Health, Dodoma, Tanzania.
LaRon E. Nelson, Yale University School of Nursing, New Haven, CT, USA.
Gaspar Mbita, Vrije Universiteit, Amsterdam, Netherlands.

Document Type

Journal Article

Publication Date

10-2-2024

Journal

BMC health services research

Volume

24

Issue

1

DOI

10.1186/s12913-024-11586-9

Keywords

HIV; HIV self-testing; Men; Tanzania

Abstract

BACKGROUND: According to the 2016-2017 Tanzania HIV Impact Survey, only 45% of men living with HIV (MLWH) were aware of their HIV status. In an effort to increase HIV testing in Tanzania, including among men, the Government of Tanzania passed a law in December 2019 allowing HIV self-testing (HIVST) to be included in the national testing strategies. The objective of this paper is to describe the development and pilot feasibility assessment of the Self-Testing Education and Promotion (STEP) intervention, which includes male peer education and demand creation for HIVST, and nurse-led distribution of HIVST kits in a community setting. METHODS: The development and piloting processes were guided by the ADAPT-ITT model and informed by a national PEPFAR/USAID-funded HIV implementation science project called Sauti. The adapted STEP intervention included the following two components: 1) peer-based HIVST promotion; and 2) nurse-led HIVST distribution. For the feasibility assessment, 25 men were selected and trained as peer educators in 2019 to promote HIVST among their peers before recruiting 253 men who received instructions and an HIVST kit from a nurse at a community-based study tent site. RESULTS: Of the 236 participants who completed the 1-month follow-up survey, 98.3% reported using the kit. The majority (92.4%) of participants reported a negative HIVST result while 4.2% (n = 10) received a positive result. Most (70%, n = 7) of the participants with a positive result sought follow-up services at a healthcare facility while 40.3% (n = 95) of the participants with a negative self-test result visited the community-based project site. Most of the men (53%, n = 129) did not visit a healthcare facility or the study site. CONCLUSION: The findings demonstrate that the combined peer-based promotion and nurse-led distribution of HIVST intervention was acceptable and feasible, though seeking follow-up services at healthcare facilities remained low. Future research should evaluate the effectiveness of offering nurse-led community-based clinical follow-up services in addition to HIVST rather than referral to facilities.

APA Citation

Conserve, Donaldson F.; Abu-Ba'are, Gamji Rabiu; Janson, Samuel; Mhando, Frank; Munisi, Grace V.; Drezgic, Busara; Rehani, Abubakar; Sims, Wynton; Ritchwood, Tiarney D.; Choko, Augustine T.; Mushy, Stella E.; Johnson, Cheryl; Jennings Mayo-Wilson, Larissa; Komba, Albert; Urasa, Peris; Nelson, LaRon E.; and Mbita, Gaspar, "Development and feasibility of the peer and nurse-led HIV Self-Testing Education and Promotion (STEP) intervention among social networks of men in Dar es Salaam, Tanzania: application of the ADAPT-ITT model" (2024). GW Authored Works. Paper 5883.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5883

Department

Prevention and Community Health