Evaluating the Effectiveness of Peer-Led HIV Self-Testing Distribution Among Copperbelt Miners in the Democratic Republic of Congo: A 2009 Programme Analysis

Mining communities in the Democratic Republic of Congo’s Copperbelt region bear a high HIV burden. Stigma and limited access constrain the use of conventional testing services. While peer-led models have potential for hard-to-reach groups, their efficacy in delivering HIV self-testing (HIVST) to miners in this setting is poorly understood. This working paper evaluates a peer-led HIVST distribution programme for Copperbelt miners. Its primary aim was to assess the programme’s effectiveness in increasing HIV testing uptake and identifying previously undiagnosed infections within this occupational group. The analysis used routine monitoring data from a peer-led initiative. Miners were trained as peer distributors to provide kits and instructions to colleagues. Data on kits distributed, the proportion used (via a results callback system), and newly identified HIV-positive results were collated for descriptive analysis. The model achieved high engagement. Over 80% of distributed kits were used. Most participants reported this was their first test in over a year. The programme identified a prevalence of previously undiagnosed HIV infection of approximately 4.2% among those tested. Peer-led distribution of HIV self-testing kits proved an effective strategy for increasing testing uptake and case-finding among Copperbelt miners, overcoming prevalent access and stigma barriers. Programme planners should integrate peer-led HIVST distribution into standard HIV services for mining communities. Operational research is required to develop effective linkage-to-care protocols following a positive self-test result. HIV self-testing, peer distribution, miners, Democratic Republic of Congo, occupational health, testing uptake. This analysis provides evidence for the effectiveness of a peer-led HIV self-testing model in a high-risk, under-served mining community, informing future programme design for similar hard-to-reach populations in the region.