Assessing awareness and use of HIV self-testing kits after the introduction of a community-based HIV self-testing programme among men who have sex with men in Kenya

PLOS Glob Public Health. 2023 Aug 18;3(8):e0001547. doi: 10.1371/journal.pgph.0001547. eCollection 2023.

Abstract

Men who have sex with men (MSM) bear a disproportionate burden of new HIV infections in Kenya, while experiencing discrimination, leading to suboptimal levels of HIV care. HIV self-testing (HIVST) is a tool to increase HIV screening and earlier diagnosis; however, questions remain regarding how best to scale-up HIVST to MSM in Kenya. The main objective of this study was to examine changes in knowledge and use of HIVST after implementation of a community-led HIVST project. Participants were MSM recruited from Kisumu, Mombasa, and Kiambu counties. Data were collected from two rounds (Round 1: 2019; Round 2: 2020) of serial cross-sectional integrated biological and behavioural assessments (IBBA), pre-, and post-project implementation. Two main outcomes were measured: 1) whether the respondent had ever heard of HIVST; and 2) whether they had ever used HIVST kits. Changes in outcomes between IBBA rounds were examined using modified multivariable Poisson regression models; adjusted prevalence ratios (aPR) and 95% confidence intervals (95% CI) are reported. A total of 2,328 respondents were included in main analyses. The proportion of respondents who had heard of HIVST increased from 75% in Round 1 to 94% in Round 2 (aPR: 1.2, 95% CI: 1.2-1.3), while those reporting using an HIVST kit increased from 20% to 53% (aPR: 2.3, 95% CI: 2.0-2.6). Higher levels of education and HIV programme awareness were associated with both outcomes. Awareness and use of HIVST kits increased after implementation of a community-led HIVST implementation project, demonstrating the importance of integration with existing community groups.

Grants and funding

SYS is supported by a Tier 2 Canada Research Chair. SM is supported by a Canadian Institutes of Health Research and Ontario HIV Treatment Network New Investigator Award. MB is supported by a Canadian Institutes of Health Research New Investigator Award. RL is supported by a Tier 2 Canada Research Chair. JB is supported by a Tier 1 Canada Research Chair. This study is made possible by the support of Bill & Melinda Gates Foundation (BMGF) under grant OPP11191068. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of BMGF. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.