Abstract

BackgroundA variety of strategies have been used to reach men with HIV self-testing services, including social network-based HIV self-test kits distribution. However, few studies have assessed men’s comfort to distribute to or receive HIV self-test kits from close male friends within the same social network. In this study, we assessed men’s comfort to distribute to and/or receive HIV self-test kits from close male friends and associated factors among men who socialize in networks locally referred to as “camps” in Tanzania.MethodsData are from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or “camps” in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. We used the Generalized Estimating Equations (GEE) to assess factors associated with being comfortable to distribute to and/or receive HIV self-test kits from close male members within one’s social network.ResultsOf 505 participants, 67.9% (n = 342) reported being comfortable to distribute to while 68.2% (n = 344) were comfortable to receive HIV self-test kits from their close male friends. Ever having heard about HIV self-testing (Adjusted Prevalence Ratio (Adj. PR): 1.6; 95% Confidence Interval [CI]: 1.3, 1.9), willingness to self-test for HIV in front of a sexual partner (Adj. PR: 3.0; 95%CI: 1.5, 6.1) and exposure to peer-led HIV self-testing education and promotion (Adj. PR: 1.4; 95%CI: 1.2, 1.7) were significantly associated with being comfortable to distribute HIV self-test kits to close male members within one’s social network. Similar results were observed for being comfortable to receive HIV self-test kits from a close male friend within one’s social network.ConclusionsOverall, these findings suggest that distribution of HIV self-test kits through close male friends could improve the proportion of men reached with HIV self-testing services and improve HIV testing rates in this population where uptake remains low. However, additional promotional strategies such as peer-led HIV self-testing education are needed to raise awareness and increase the proportion of men who are comfortable to receive and/or distribute HIV self-testing kits.

Highlights

  • A variety of strategies have been used to reach men with Human Immunodeficiency Virus (HIV) self-testing services, including social network-based HIV self-test kits distribution

  • Matovu et al BMC Public Health (2021) 21:1739. Overall, these findings suggest that distribution of HIV self-test kits through close male friends could improve the proportion of men reached with HIV self-testing services and improve HIV testing rates in this population where uptake remains low

  • Citing survey and program reports from 25 sub-Saharan African countries, the report indicated that in nearly half (12) of these countries, men living with HIV were leas likely to know their HIV status and knowledge of HIV status among men living with HIV was about half the rate found among women [2]

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Summary

Introduction

A variety of strategies have been used to reach men with HIV self-testing services, including social network-based HIV self-test kits distribution. Hegemonic masculinity norms [7], coupled with high levels of stigma and discrimination around HIV testing [8], continue to keep some men away from getting tested for HIV, coming to terms with their HIV-positive status, taking instructions from nurses, and engaging in health enabling behaviors. These dynamics contribute to poorer HIV testing uptake and treatment outcomes for men compared to women in high prevalence settings, calling for innovative approaches to reach men with HIV testing and linkage to HIV care services.

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