Replication Study: Peer-Led HIV Self-Testing Distribution and Testing Frequency Among Men Who Have Sex with Men in Mombasa, Kenya

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.