If you want to get more men tested for HIV, your best bet may be to give self-tests to their female partners, according to a new study published in PLOS Medicine.
Harsha Thirumurthy, associate professor at the University of North Carolina at Chapel Hill, uses insights from psychology and economics to alter health behaviors in low-income settings. In his recent study, he brought his expertise to bear on the problem of HIV testing.
HIV testing is an important part of the HIV prevention strategy in sub-Saharan Africa, but it has proven particularly difficult to persuade men to use testing services. One strategy aimed at reducing mother-to-child HIV transmission involves encouraging pregnant women to refer their partners for testing, but this has had limited success.
Thirumurthy and his colleagues set out to evaluate an alternative, self-testing approach: instead of asking pregnant women to bring their partners to testing clinics, they provided them with two HIV oral fluid-based self-tests and encouraged them to give one to their male partner or test with their partner. The study included 600 women aged 18–39 in Kisumu Country, Kenya, who were pregnant or had recently given birth. Half of the women were given the HIV self-tests. The other half, the comparison group, were given cards for their partners inviting them for testing at a clinic.
The provision of HIV self-tests led to an impressive 90.8 percent of partners reporting having used the tests within 3 months, while the invitation cards resulted in 51.7 percent of male partners visiting a clinic for testing. However, these findings relied on self-reported outcomes. The authors were also concerned that around a third of women screened for participation declined to take part in the trial, in some cases reporting a fear that violence could result from offering a self-test to their partner, so this strategy might not work for everyone.
Nonetheless, the authors describe their results as “promising” and note that “secondary distribution of self-tests warrants further consideration as countries develop HIV self-testing policies and seek new ways to promote partner and couples testing.”
Research Article: Masters SH, Agot K, Obonyo B, Napierala Mavedzenge S, Maman S, Thirumurthy H (2016) Promoting Partner Testing and Couples Testing through Secondary Distribution of HIV Self-Tests: A Randomized Clinical Trial. PLoS Med 13(11): e1002166. doi:10.1371/journal.pmed.1002166
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