A Policy Brief on Community-Led Door-to-Door Distribution of HIV Self-Testing Kits for Men in North West Province Mining Communities

Men in South Africa's mining communities, such as those in the North West Province, have persistently lower HIV testing rates than women. Structural barriers, including long working hours, mobility, and stigma, limit their use of conventional clinic-based services. Male-friendly strategies are needed to close this testing gap. This policy brief evaluates a pilot intervention of community-led, door-to-door distribution of HIV self-testing (HIVST) kits. The primary objective was to assess the feasibility, acceptability, and preliminary effectiveness of this model in increasing HIV testing uptake among men in these mining communities. The intervention trained local community health workers and peer distributors from mining settlements to conduct door-to-door outreach, offer education on HIVST, and distribute kits. A mixed-methods evaluation incorporated programme data on kits distributed and returned, alongside focus group discussions with beneficiaries and distributors. The model demonstrated high acceptability. Preliminary data indicated a threefold increase in testing uptake among targeted men compared to prior facility-based outreach in the same areas. Qualitative data identified that home-based distribution by trusted local figures reduced perceived stigma and accommodated shift patterns. Community-led, door-to-door distribution of HIVST kits is a feasible and acceptable strategy to reach men in mining communities who are underserved by static health facilities. It addresses key logistical and social barriers to testing. Integrate community-led HIVST distribution into provincial HIV programming with dedicated funding. Scale up training for local community-based organisations and peer distributors. Establish clear referral pathways for confirmatory testing, counselling, and linkage to care for reactive results. HIV self-testing, men, mining communities, community health workers, door-to-door distribution, South Africa. This brief provides evidence for policymakers on an effective, community-based model to improve HIV testing coverage among a high-priority, underserved male population.