Effectiveness of distributing HIV self-test kits through MSM peer networks in Uganda

CROI 2019 Stephen Okoboi1, 2 Oucul Lazarus3, Barbara Castelnuovo1, Collins Agaba3, Mastula Nanfuka3, Andrew Kambugu1 Rachel King4,5 POSTER P-S3 0934 1. Infectious Diseases institute, 2.Clarke International University; 3.The AIDS Support Organization (TASO) ; 4.University of California, San Francisco; Global Health; 5.School of Public Health, Makerere University. .

Background Results Conclusions/Recommendation

• Men who have sex with men (MSM) continue to be •MSM peers distributed a total of 150 HIVST kits to • Our pilot findings suggest that distributing disproportionately impacted globally by the HIV epidemic and MSM participants. HIVST through MSM peer-networks is are also highly stigmatized in Uganda. feasible, effective and a promising •A total of 10 participants were diagnosed with HIV strategy to increase uptake of HIV testing • Peer-driven HIV testing strategies can be effective in infection during the 3 months of kits distribution. and reduce undiagnosed infections identifying undiagnosed infections among high risk among MSM in Uganda populations •This was higher than 4/147 (2.7%) observed in the TASO program Jan-March 2018 (P=0.02). • Based on the pilot results, additional • We examined peer HIV oral fluid self-test kits (HIVST) studies to determine the large-scale network distribution effectiveness in identifying undiagnosed •All diagnosed HIV participants disclosed their test effectiveness of this strategy to overcome HIV infection among MSM in The AIDS Support Organization results to their peers, were confirmed HIV positive the barriers and increase HIV testing (TASO). at a health facility, and initiated on ART. among those most vulnerable to infection is needed Methods •Compared to TASO MSM testing programs, 77% of the MSM reached through the peer HIVST distribution had never tested or tested in the last • We also need to determine if this strategy • From June to August 2018, We identified 15 MSM peers from 12 months is replicable in other high risk populations TASO Masaka and Entebbe and trained them in Ora-Quick Fig 1: Flow chart comparing HIVST Distribution with standard of in Uganda oral fluid based second generation HIVST and basic HIV care HIV Testing counselling • To examine the cost effectiveness of this strategy is critical • After training, MSM peers were each given to distribute 10 HIVST kits through one wave to MSM who have never tested in the previous six months and link participants who test positive to care. PRESENTING AUTHOR: Stephen Okoboi Infectious Diseases Institute • We then compared MSM peer HIVST kits distribution strategy Makerere University to TASO MSM community and hotspot testing approaches in [email protected] identifying undiagnosed HIV infection using fisher exact test Acknowledgement statement

This project has been supported by UCSF CFAR International Mentored Scientist Award; NIH P30-AI027763