Abstract

Announcing the availability of oral HIV self-test kits via text message to increase HIV testing among truckers in Kenya: A randomized controlled trial

Elizabeth Kelvin, PhD, MPH1, Gavin George, PhD, MCom2, Samuel Kinyanjui, MSC3, Eva Mwai, BA3, Matthew Romo, PharmD, MPH1, Faith Oruki3, Jacob Odhiambo3, Eston Nyaga, BA3, Joanne Mantell, MS, MSPH, PhD4 and Kaymarlin Govender, PhD, MA2
(1)CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, (2)University of KwaZulu-Natal, Durban, South Africa, (3)North Star Alliance, Nairobi, Kenya, (4)New York State Psychiatric Institute and Columbia University, New York, NY

APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)

Background: Truckers in sub-Saharan Africa are at high risk for HIV, but their work may make accessing HIV testing difficult. We assessed whether informing truckers about the availability of HIV self-testing kits using text messages would increase HIV testing rates. Methods: We selected 2,262 Kenyan truckers registered in the electronic health record system of a roadside clinic network in Africa and who, based on these records, were irregular HIV testers. Participants were randomized to receive text messages about the availability of (1) HIV self-test kits at all eight clinics in Kenya sent three times (intervention), (2) HIV testing in general at all clinics sent three times (enhanced standard of care (SOC)), or (3) HIV testing in general at all clinics sent one time (SOC). Those in the intervention group who visited a clinic were offered a choice among (1) the standard provider-administered blood-based HIV test, (2) an oral HIV self-test for use in the clinic with supervision or (3) the oral HIV self-test kit to take for home use with phone-based posttest counseling. Results: Truckers in the intervention group had significantly higher odds of HIV testing during the 2-month follow-up compared to those in the enhanced SOC (OR=2.7, p=0.009). There was no difference between those in the enhanced SOC and the SOC groups (OR=1.0, p=0.967). Of those in the intervention group who tested, 35.5% chose the standard test, 48.4% the self-test with supervision, 16.1% took a self-test kit for home use. Conclusions: Announcing the availability of HIV self-testing at clinics via text message increased HIV testing among this sample of truckers who were not accessing HIV testing regularly. However, when offered HIV testing choices, truckers varied in the method they chose, suggesting that HIV testing choices may be important to maximize uptake.

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