The Effect of HIV Self-Testing Delivery Models on Female Sex Workers’ Sexual Behaviors: A Randomized Controlled Trial in Urban Uganda

• Published in: AIDS and behavior Vol. 23; no. 5; pp. 1225 - 1239
• Main Authors: Ortblad, Katrina F., Kibuuka Musoke, Daniel, Ngabirano, Thomson, Nakitende, Aidah, Harling, Guy, Haberer, Jessica E., McConnell, Margaret, Salomon, Joshua A., Oldenburg, Catherine E., Bärnighausen, Till
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-05-2019; Springer Nature B.V
• Subjects: Adult; Clinical trials; Evidence-based medicine; Female; Health Psychology; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - psychology; Human immunodeficiency virus; Humans; Infectious Diseases; Mass Screening - methods; Medical tests; Medicine; Medicine & Public Health; Original Paper; Prostitution; Public Health; Randomization; Risk taking; Self testing; Self tests; Serologic Tests - methods; Sex; Sex differences; Sex industry; Sex workers; Sex Workers - psychology; Sex Workers - statistics & numerical data; Sexual behavior; Sexual Behavior - statistics & numerical data; Sexually transmitted diseases; Statistical analysis; STD; Uganda - epidemiology; Urban areas; Workers; Uganda; Condom use; Female sex workers; Uganda; HIV self-testing; Sexual behaviors
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-019-02393-z

HIV self-testing increases recent and frequent HIV testing among female sex workers (FSWs) in urban Uganda. Using results from a randomized controlled trial, we aim to establish the effect of HIV self-testing delivery models on FSWs’ sexual behaviors in this setting. Clusters of one peer educator and eight participants were 1:1:1 randomized to: (1) direct provision of an HIV self-test, (2) provision of a coupon for facility collection of an HIV self-test, or (3) referral to standard-of-care HIV testing services. Sexual behaviors were self-reported at 1 and 4 months. From October to November 2016, 960 participants were enrolled and randomized. At 4 months, there were no statistically significant differences in participants’ sexual behaviors, including inconsistent condom use, across study arms. We do not find any changes in sexual risk-taking among FSWs in response to the delivery of HIV self-tests. Routine policies for HIV self-testing are likely a behaviorally safe component of comprehensive HIV prevention strategies.