African Journal of Public Health and Health Systems | 07 October 2022
Replication Study: Peer-Led HIV Self-Testing Distribution and Testing Frequency Among Men Who Have Sex with Men in Mombasa, Kenya
J, a, m, e, s, O, m, o, n, d, i, ,, W, a, n, j, i, k, u, M, w, a, n, g, i, ,, S, a, m, u, e, l, K, a, r, i, u, k, i, ,, F, a, t, i, m, a, H, a, s, s, a, n
Abstract
HIV self-testing is a strategic approach to improve testing coverage among key populations, including men who have sex with men. A prior study in another Kenyan context found peer-led distribution of self-testing kits increased testing frequency. This replication study assessed the intervention’s effectiveness within the MSM community in Mombasa, a coastal urban centre with distinct socio-cultural dynamics. The purpose was to replicate the evaluation of a peer-led HIV self-testing distribution model and its effect on testing frequency among MSM in Mombasa. The objective was to compare the proportion of participants testing at least twice in a 12-month period between an intervention group receiving peer-distributed self-tests and a control group receiving standard facility-based testing referrals. A quasi-experimental study was conducted. MSM were recruited via peer networks and community-based organisations. Participants were non-randomly allocated to an intervention arm, where trained peer educators provided self-testing kits with demonstration and support, or a control arm receiving enhanced standard care including counselling and clinic referrals. Data on testing behaviour were collected via structured questionnaires at baseline and follow-up. The intervention group reported a significantly higher proportion of participants testing at least twice compared to the control group (68% versus 42%). Peer-led distribution was associated with a reduction in reported barriers related to stigma and clinic access. This replication confirms that peer-led distribution of HIV self-testing kits is an effective strategy for increasing HIV testing frequency among MSM in Mombasa. The findings support the scalability of this community-based model in similar urban Kenyan settings. HIV programmes aiming to increase testing uptake among MSM in coastal Kenya should integrate peer-led HIV self-testing distribution. Policy and funding should support the formal inclusion of this model within national testing guidelines for key populations. HIV self-testing, men who have sex with men, peer-led distribution, testing frequency, replication study, Kenya. This study provides replicated evidence from a distinct socio-cultural context, strengthening the empirical basis for scaling up peer-led HIV self-testing interventions among MSM in coastal urban Africa.