Tools
Tools
Sibanda, Euphemia 
ORCID: https://orcid.org/0000-0003-1754-1076, Mangenah, Collin, Neuman, Melissa, Tumushime, Mary, Watadzaushe, Constancia, Mutseta, Miriam N, Maringwa, Galven, Dirawo, Jeffrey, Fielding, Katherine L, Johnson, Cheryl, Ncube, Getrude, Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536, Hatzold, Karin, Corbett, Elizabeth Lucy, Terris-Prestholt, Fern and Cowan, Frances ORCID: https://orcid.org/0000-0003-3087-4422
(2021)
'Comparison of community-led distribution of HIV self-tests kits with distribution by paid distributors: a cluster randomised trial in rural Zimbabwean communities'. BMJ Global Health, Vol 6, Issue Suppl_4, e005000.
|
Text
bmjgh-2021-005000.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. Download (3MB) | Preview |
Abstract
Background: We compared community-led versus an established community-based HIV self-testing (HIVST) model in rural Zimbabwe using a cluster-randomised trial. Methods: Forty village groups were randomised 1:1 using restricted randomisation to community-led HIVST, where communities planned and implemented HIVST distribution for 4 weeks, or paid distribution (PD), where distributors were paid US$50 to distribute kits door-to-door over 4 weeks. Individual level primary outcomes compared household survey responses by arm 4 months post-intervention for: (1) newly diagnosed HIV during/within 4 months following HIVST distribution, (2) linkage to confirmatory testing, pre-exposure prophylaxis or voluntary medical male circumcision during/within 4 months following HIVST distribution. Participants were not masked to allocation; analysis used masked data. Trial analysis used random-effects logistic regression. Distribution costs compared: (1) community-led HIVST, (2) PD HIVST and (3) PD costs when first implemented in 2016/2017. Results: From October 2018 to August 2019, 27 812 and 36 699 HIVST kits were distributed in community-led and PD communities, respectively. We surveyed 11 150 participants and 5683 were in community-led arm. New HIV diagnosis was reported by 211 (3.7%) community-led versus 197 (3.6%) PD arm participants, adjusted OR (aOR) 1.1 (95% CI 0.72 to 1.56); 318 (25.9%) community-led arm participants linked to post-test services versus 361 (23.9%) in PD arm, aOR 1.1 (95% CI 0.75 to 1.49. Cost per HIVST kit distributed was US$6.29 and US$10.25 for PD and community-led HIVST, both lower than 2016/2017 costs for newly implemented PD (US$14.52). No social harms were reported. Conclusions: Community-led HIVST can perform as well as paid distribution, with lower costs in the first year. These costs may reduce with programme maturity/learning. Trial registration number: PACTR201811849455568.
Statistics
Actions (login required)
 |
Edit Item |