Abstract
Background and objectives: Available evidence shows a low uptake of HIV services among men in Rwanda. HIV self-testing (HIVST), a new intervention, may have the potential to improve the uptake of HIV testing services among men. The current study aims to adapt a health education program (HEP) for improving the uptake of HIVST among men in Rwanda. Materials and Methods: We propose a mixed method study, which will be conducted in four phases. In Phase 1, we will conduct a scoping review to map the available evidence on health education programs for men in low- and middle-income countries (LMICs). In Phase 2, we will conduct interviews with stakeholders in the Rwanda HIV response and healthcare providers to determine their perspectives on implementation of HIVST in Rwanda. In Phase 3, a cross-sectional survey will be used to assess HIVST awareness and acceptability among men in Rwanda. Guided by findings from Phases 1, 2, and 3, we will employ the nominal group technique to develop and optimize the HEP for improving the uptake of HIVST among men in Rwanda. In Phase 4, we will use a pragmatic pilot randomized controlled trial to assess the preliminary impact of the HEP for men in Rwanda and assess the feasibility of a later, larger study. We will employ the Stata version 16 statistical package and NVivo version 12 for the analysis of quantitative and qualitative data, respectively. We anticipate that the findings of this study will inform implementers and policy makers to guide strategies on the implementation of HIVST in Rwanda and ultimately accomplish goals set forth in the Rwanda 2019–2024 Fourth Health Sector Strategic Plan on scaling up the number of men who know their HIV status. Conclusion: It is anticipated that this study will proffer solutions and strategies that are applicable not only in Rwanda but also in similar settings of LMICs.
Highlights
Background and objectivesAvailable evidence shows a low uptake of Human immunodeficiency virus (HIV) services among men in Rwanda
Different interventions that aim to scale up HIV diagnosis, antiretroviral therapy (ART) initiation, and care continuum have led to most countries nearing epidemic control [2,3]
It is anticipated that the results of this will proffer solutions and strategies that are applicable for men in similar settings of low- to middle-income countries (LMICs)
Summary
Human immunodeficiency virus (HIV) currently remains a major public health problem in Rwanda. For prevention and treatment interventions, the importance of knowing one’s HIV status cannot be over-emphasized While this is the case, men (ranging between 51% and 70%) lag behind women (ranging between 71% and 84%) on the uptake of HTSs, a gap threatening the progress towards the. Organization (WHO) published the first global guidelines on HIV self-testing (HIVST) in 2016 [17]—an intervention that has shown global potential to increase uptake of HTSs [13,18,19,20,21]. With HIVST being offered to men in health care facility-based settings [22,23] and community settings [22], in Malawi, Zambia, and Zimbabwe. It is anticipated that the results of this will proffer solutions and strategies that are applicable for men in similar settings of low- to middle-income countries (LMICs)
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