Thematic Window HIV Self-Testing, Zambia

3ie requested proposals from organisations to implement projects, which include a pilot intervention to use HIV self-tests in Zambia as well as an impact evaluation of that pilot intervention.

This request for proposals was part of phase 2 of this grant window. Under phase 1, 3ie commissioned one formative research study to define the local environment surrounding HIV self-testing in Zambia.

The purpose of this request for proposals was to fund innovative pilot interventions to introduce the use of HIV self-tests to increase testing rates or testing frequency in Zambia and fund the rigorous impact evaluations of those pilot interventions in order to produce robust and actionable evidence of what works or what is most effective and cost-effective among those interventions. 

The window is designed to provide the Government of Zambia the evidence they want and need to best incorporate HIV self-tests into their national HIV and AIDS programme.

For more information and instructions on how to apply, please download the  Request for proposals (RFP) (297.4 KB)

This call is now closed. The deadline for this RFQ was 23:59 GMT, 29 September 2015.

3ie is making available answers to the questions it received regarding this RFP. The deadline for submitting questions was 1 September 2015. Please download the Q&A document (246.5 KB)

Any other queries regarding this RFP should be submitted to tw2@3ieimpact.org

Award winners

A peer educator-delivered HIV self-testing intervention for female sex workers in Zambian border towns

Principal Investigator: Till Bärnighausen
Organisation: Harvard TH Chan School of Public Health

This study seeks to evaluate the impact of a pilot programme that establishes a preferred distribution mechanism of HIV self-tests for female sex workers (FSW) in three of Zambia’s busiest border towns, Chirundu, Kapiri, and Livingstone. The study will also evaluate linkage to care among individuals testing positive via HIV self-tests. The study will individually randomise 750 FSWs to one of the three study arms. HIV self-tests will be distributed through two distinct mechanisms: (1) through referring FSWs to fixed distribution points for HIV self-tests in addition to standard of care counselling; and (2) through direct distribution of HIV self-tests and referral agents for necessary services, and the third arm will receive standard of care, which is counselling and referral to a clinic for testing.  

The study will address whether providing HIV self-tests through peer educators, health facilities or drug stores to FSW would be a viable and cost-effective solution to reach this higher risk population. The evidence from this study will allow for a better understanding of how best to implement HIV self-testing at scale so that it is the most acceptable and accessible to FSW in these regions of Zambia.

Community-based distribution of oral HIV self-testing kits: a pilot intervention and rapid impact evaluation

Principal investigator: Alwyn Mwinga
Organisation: Zambart

The study seeks to evaluate the impact of a pilot programme that distributes HIV self-testing (HIVST) kits through community healthcare workers (CHW) to increase the uptake of HIV testing services among the general adolescent and adult population in Zambia. The study will link HIV treatment and care or prevention services to individuals according to the result of their self-test. The study will randomise 66 zones in four communities to receive the pilot HIVST intervention or the standard rapid HIV testing performed by a CHW, with randomisation stratified by community. The study will offer services to approximately 66,000 individuals across the 66 zones. 

CHWs will conduct follow-up visits to households where HIVST kits were distributed to provide post-test counselling support. Individuals for whom the HIVST kit was intended will be provided with counselling appropriate to the result of their self-test. If the test was reactive, CHW will perform confirmatory HIV-testing and facilitate linkage to HIV care and treatment services. Where the test was not reactive, the CHW will link the individual to prevention services.

Evidence from this study will provide significant information on HIV-testing among the general population and sub-population not being reached by existing strategies. It will also offer evidence on the impact on the proportion of people living with HIV who link to care. This study will provide evidence critical to informing the national HIV testing strategy in Zambia and in other resource-poor countries.

At a glance

  • 3ie expects to fund two grants of no more than US$450,000. Each grant will fund one project, and each project will combine both the implementation of the pilot intervention and the conduct of the impact evaluation.
  • The call is open to organisations implementing HIV and AIDS programmes in Zambia. For-profit organisations are also eligible to apply.
  • While grant money can be used to fund the implementation, it is expected that most of the intervention will be funded using other resources, with 3ie grant funding used for the impact evaluation and for adjustments or additions to current programming to facilitate the impact evaluation.
  • Organisations may submit more than one proposal and may be included on more than one proposal. They should, however, have the capacity to implement and evaluate any and all grants awarded to them under the window.
  • A team applying for a grant may include multiple organisations e.g., one organisation that will implement the pilot programme and one organisation that will conduct the impact evaluation. But a single organisation must apply for the grant as the prime grantee and then issue sub-awards to other team members.

How to apply

For instructions on how to apply, please read the RFP and visit the How to Apply page to download requisite documents for your application.

Any questions about this window or call for proposals should be sent to tw2@3ieimpact.org

About 3ie’s Thematic Window 2 on HIV Self-Testing, Zambia

  • The goal of this grant window is to provide evidence that the Ministry of Community Development, Mother and Child Health and the Ministry of Health can use in determining whether and how to implement and scale up the availability of HIV self-tests and related services such as access to counselling and linkage to care. 
  • In 2014, 3ie made an award to the Centre for Infectious Disease Research in Zambia for a feasibility study on HIV self-testing under phase 1 of this grant window. More details about the study can be found in the next section on this page. 
  • The formative research study will inform the design of pilot programmes using HIV self-tests to be implemented and evaluated using rapid impact evaluations in phase 2 of this grant window.
  • 3ie hosted a matchmaking event in Zambia in August 2015 for researchers and HIV and AIDS programme implementers intending to submit a proposal to 3ie’s Thematic Window 2 for evaluating pilot programmes using HIV self-tests in Zambia. The primary aim of this impact evaluation matchmaking event was to match health researchers who have strong knowledge of impact evaluations, researchers working on HIV prevention and/or HIV self-testing in Zambia and HIV and AIDS programme implementers, to explore possibilities of partnership.

Thematic Window 2 Phase 1 Award Winner, Zambia

Principal investigator: Arianna Zanolini
Organisation: Centre for Infectious Disease Research in Zambia 

The Centre for Infectious Disease Research in Zambia conducted a six-month formative study that investigated factors influencing acceptability of HIV self-tests, potential methods to ensure linkage to care and the feasibility of implementing an HIV self-testing programme specific to the population and health system. The research explored whether individuals, particularly those who have never tested for HIV, would be likely to take up self-testing. It also explored the best way to disseminate or market self-testing to these individuals and how linkage to care can be reinforced among those who take up this novel testing mechanism.

Download grantee final report (520.2 KB)

© Rohit Ramchandani

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