Access to HIV self-tests in Kenya

"The effect of providing women sustained access to HIV self-tests on male partner testing, couples testing, and HIV incidence in Kenya: a cluster-randomised trial" is a new paper by Harsha Thirumurthy, Elizabeth F. Bair, Perez Ochwal, Noora Marcus, Mary Putt, Suzanne Maman, Sue Napierala, and Kawango Agot.

The paper was published in The Lancet HIV and explores the effect of providing women sustained access to HIV self-tests. Dr. Thirumurthy spoke to Penn Today about four takeaways from the study.

From Penn Today:

The five-year project funded by the National Institutes of Health was a cluster-randomized trial conducted among 2,090 women who self-reported multiple sexual partners and lived in areas with high prevalence of transactional sex and HIV. It is the first study to evaluate whether access to free HIV self-tests for an extended period of time enables women to become more aware of their current and potential partners’ HIV status and to reduce their risk of acquiring HIV.

The researchers found that providing women with sustained access to HIV self-tests had no significant effect on HIV incidence, but that women who received self-tests were much more likely to learn their male partners’ HIV status and get tested as a couple. Women in the intervention group were also more likely to report that they declined sex or used a condom after a partner either tested HIV-positive or refused to test for HIV. 

Thirumurthy offers four takeaways from the study and HIV awareness generally:

1. Tapping into social networks and sexual networks can help to achieve public health objectives

In health care and public health, we’re often trying to affect behavior change in populations that are hard to reach or engage. What this study shows is that working through communities and people’s own social networks and sexual networks can yield much more success than trying directly to go to those individuals as a health care provider. 

The usefulness of this approach extends beyond HIV testing. At the beginning of the COVID pandemic we were trying to encourage people to test for COVID. For a variety of reasons, there are many who would be unlikely to visit a testing facility to get tested. But if you could send someone home with two or three COVID tests, that person may be able to distribute the COVID test to other people they know who might be at high risk. So that’s another example of how networks could be used to achieve public health objectives.