3ie ~ International Initiative for Impact Evaluation

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Thematic Window HIV Self-Testing

3ie invited expressions of interest (EOI) from implementing agencies and researchers to participate in an impact evaluation matchmaking event on 28 and 29 April 2014 in Nairobi, Kenya.

Expressions of interest were invited from implementers and researchers who are looking for a partnership to submit a proposal to 3ie’s Thematic Window for evaluating pilot programmes using HIV oral self-tests. This window will provide grants for implementing pilot interventions using HIV oral self-tests in Kenya as well as conducting rapid impact evaluations of these pilot interventions. 

The results of the formative research that will inform the design of the pilot programmes will be presented at the matchmaking event. The formative research was funded under Phase 1 of 3ie’s Thematic Window. 

This request for expressions of interest is now closed.

About 3ie’s Thematic Window 2 on HIV self-testing

Although HIV self-tests may be a useful tool for encouraging individuals to know their status, little is known about potential users, methods of delivery, and linkage to care. Critically, more knowledge about potential social harms is vital for policymakers and health-care providers seeking to make self-tests available as a method to address the HIV/AIDS epidemic.

3ie identified a number of key questions related to HIV self-tests by reviewing self-testing and rapid diagnostic testing literature and by meeting with key stakeholders in Kenya. 3ie and NASCOP selected six of these questions in a request for applications, with the intention of funding at least one project addressing each question. This was under Phase 1 of 3ie Thematic Window 2 on HIV self- testing. The call was open to organisations implementing HIV/AIDS programmes in Kenya.

  • Question 1: Is the use of the oral self-test in real-life situations in Kenya accurate (including both sensitivity and specificity)?
  • Question 2: How should oral self-tests be packaged and labeled?
  • Question 3: Who is likely to seek oral self-testing? What are the incentives of different types of individuals to self-test? What messaging and other methods might be effective for increasing the acceptability and demand for self-tests, particularly among groups that self-testing might want to target?
  • Question 4: What are likely to be the most effective and efficient outlets and/or networks for distributing self-tests to potential users? What programme design features might be specific to different distribution outlets?
  • Question 5: What methods are likely to be effective for ensuring counselling and linkage to care for those using self-tests?
  • Question 6: What are the potential social harms from the availability and use of self-tests? How might risks, such as self-tests administered to others by coercion, be avoided?

Six awards were made under Phase I of 3ie’s Thematic Window 2 on HIV Self-Testing to conduct formative research related to the design, implementation, and evaluation of interventions using HIV oral self-tests in the Republic of Kenya.

The studies produced will inform Phase II of the thematic window, which will provide grants for pilot programmes using HIV oral self-tests to be implemented and evaluated using rapid impact evaluations. 

To read more about the formative research funded under Phase 1 of 3ie’s Thematic Window 2 on HIV Self- Testing, visit the Thematic Window 2 Phase I Award Winners page.

Phase I of Thematic Window 2 has been coordinated with Kenyan National STI & AIDS Control Programme (NASCOP) and with the Bill & Melinda Gates Foundation.

Background

The Kenyan government is a strong proponent of innovative methods for HIV prevention and treatment. The government has successfully implemented home-based HIV testing, and they are interested in research that will provide insights for the design of a HIV self-testing programme. With their experience and knowledge of HIV prevention programmes and the Kenyan context, NASCOP was a prime partner for this grant window.

HIV testing in Kenya has increased over the last 5 years–the 2012 Kenya AIDS Indicator Survey reported that the percentage of people aged 15-64 who have ever been tested for HIV increased from 34 per cent in 2007 to 72 per cent (80 per cent for women, 63 per cent for men) in 2012, yet only 47 per cent of HIV positive individuals know their status (NASCOP, 2012). While different approaches including voluntary counselling and testing, provider-initiated counselling and testing, mobile testing, and home-based testing have been used to increase the uptake of HIV testing, coverage is still below the 80 per cent goal and many HIV positive individuals are still unaware of their HIV status. If HIV oral self-testing can overcome some of the barriers to seeking HIV testing, it could provide an option that could complement existing approaches.