Background: In sub-Saharan Africa, men are harder to reach with HIV-testing services (HTS) than women. HIV self-testing (HIVST) and secondary distribution of HIVST are strategies that may increase men''s HTS uptake. Measuring HIVST outcomes through secondary distribution is challenging. In a cluster-randomised trial of door-to-door offer of HIVST as an option for HTS, lay counsellors also offered HIVST for secondary distribution to absent partners. We describe characteristics of individuals accepting HIVST for their partner and of individuals for whom a secondary distribution HIVST result was recorded.
Methods: This study was nested within a community-randomised trial of a universal test-and-treat intervention (HPTN071(PopART)). Sixty-six zones in four PopART communities were randomized to the HIVST intervention or PopART standard-of-care. In HIVST intervention clusters, lay counsellors offered individuals choosing to test the option of HIVST or finger-prick HIV-testing. Individuals aged ≥18-years whose partner was absent were offered HIVST for this partner. We describe characteristics of individuals accepting a secondary distribution HIVST and of the individuals for whom a secondary distribution HIVST result was recorded. In this abstract, data on use and results of secondary distribution HIVST are reported by the distributor.
Results: In HIVST clusters, 9.0% (n=822) of 9,105 individuals aged ≥18-years seen by lay counsellors accepted a secondary distribution HIVST (Table). 89.4% (n=735/822) were female and 2.1% (n=17/822) self-reported their HIV-positive status. Half (n=401/822; 48.8%) reported that their partner used the distributed HIVST. Among the 3,105 individuals absent at a first household visit, results of secondary distribution HIVST were recorded for 10.4% (n=323); 87.6% (n=283/323) were male, 66.6% (n=215/323) were aged ≥30. 38.7% (n=125) had not previously been seen in the PopART intervention as they had only recently become resident, 8.7% (n=28) were resident but had not previously participated in PopART; 10.2% (n=33) previously declined an offer of HTS.
Conclusions: In this trial, relatively few HIVST were distributed for secondary use. About half of secondary distribution HIVST were reportedly unused by study end-date. Secondary distribution reached men, and individuals who previously declined to participate in PopART or an offer of HTS. Targeted secondary distribution of HIVST could be considered in settings where men are harder-to-reach with HTS.



[Characteristics of individuals accepting an HIVST for secondary distribution and those reported to have used a secondary distribution HIVST]