3ie is pleased to announce three awards under phase 2 of its second Thematic Window on HIV Self-Testing in Kenya.
3ie’s Thematic Window 2 operates under two separate phases in Kenya — phase 1 funds formative research and phase 2, funds pilot interventions and their impact evaluations.
Under phase 1, 3ie commissioned six formative research studies to define the local environment surrounding HIV self-testing in Kenya and inform phase 2 pilot programmes. These are available for download here . Under phase 2 of this funding window, 3ie accepted proposals from organisations to implement pilot interventions to introduce the use of HIV oral self-tests in the Republic of Kenya and conduct impact evaluations of those innovative programmes.
The pilot programmes being funded under phase 2 must be interventions meant to use HIV oral self-tests to increase testing rates generally and/or increase the frequency of testing among targeted populations. The impact evaluations of the pilot programmes funded under this grant window will produce robust and actionable evidence on how to safely and effectively promote HIV oral self-testing as an additional HIV testing option in the Republic of Kenya.
A randomised controlled trial to evaluate adding self-administered oral HIV testing as a choice in clinic and non-clinic settings to increase HIV testing uptake among truck drivers in Kenya
Principal Investigators: Elizabeth Kelvin
Organisation: City University of New York, Hunter College
The study seeks to evaluate the impact of a pilot programme that offers alternative approaches to HIV testing on the uptake of testing among truck drivers in Kenya. This study will randomly assign 300 English and/or Kiswahili-speaking truck drivers that visit two North Star Alliance clinics into two study arms. Participants in one study arm will be offered standard provider-administered HIV blood tests, and while those in the second treatment arm will be offered a choice of a standard HIV blood test or a supervised self-administered oral test. All 300 participants will be followed for the duration of the study and will be offered text message reminders on the importance of follow-up testing at three months post-baseline. Additionally, clients that take self-administered tests will be asked to return to any one of North Star Alliance’s seven clinics within three to six months to pick up a second HIV oral self-test. The study intends to address some of the barriers to HIV testing among truck drivers including issues of privacy and confidentiality, long wait times to get results and get tests done, and irregular schedules of the truck drivers.
Increasing male partner testing at antenatal care clinics in Kenya
Principal Investigator: Anthony Gichangi
The study seeks to evaluate the impact of oral HIV self-tests offered at antenatal care (ANC) clinics on the acceptability and uptake of male partner testing in Kenya. The study will also evaluate several secondary outcomes including linkage to care, HIV test results and information provided by the male partner. The study will individually randomise approximately 1,425 pregnant women who are visiting an ANC clinic within 14 designated hospitals into three treatment arms. Pregnant women in the first study arm will receive standard ANC including a standard letter addressed to the client’s male partner that invites him to join the client on her next ANC visit. Pregnant women in the second study arm will receive standard ANC, but including an improved letter that shares specific information on HIV, the prevalence of serodiscordant couples, and ways to preventing mother-to-child transmission of HIV. The third study arm, which is the intervention group, will receive the improved letter, a standard HIV test administered on site, and two self-testing kits (with instructions on how to use them) for the client to take home and use with her partner.
Women in all three groups will receive counselling and instructions on how best to approach the topic of HIV testing with their partner. Additional follow up includes text message reminders that will be sent to all three groups, and an endline questionnaire will be sent out at 12 weeks post-enrolment. Evidence from this study will provide significant information on how best to increase HIV testing among men and couples.
The use of HIV self-tests to promote partner and couples testing: a randomised trial
Principal Investigators: Harsha Thirumurthy and Kawango Agot
Organisation: University of North Carolina, Chapel Hill
The study seeks to evaluate the impact of home-based HIV self-tests provided at antenatal care (ANC) clinics on the uptake of couple and/or male partner testing. The study will also evaluate several secondary outcomes which include discussing HIV testing with partner, couple self-testing (testing together) versus separate testing, risk behaviour, HIV status disclosure to partners, post-test sexual behaviour and decision making, and adverse reactions to positive or discordant results. The study will individually randomise 580 pregnant and postpartum women that visit the Lumumba Health Clinic and report having a primary partner into two study arms. Women in the first study arm will receive standard care and a referral letter encouraging the partner to get tested, and women in the second arm will receive standard care and two self-test kits to take home.
Additionally, women in the intervention group will receive counselling and instructions on how to use the self-testing kit and how best to broach the topic of HIV self-testing with their partner. All participants will be followed for the duration of the study and will be contacted at three months post-enrolment for follow-up interviews.
The study intends to address some of the barriers to HIV testing among partners including stigma, economic costs and social norms that inhibit male participation in health care. Evidence from this study will provide important information on how best to increase HIV testing among men.