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Mhando F, Olughu K, Nyankomo M, Ngocho JS, Teri I, Mbita G, Conserve DF. Men's Willingness to Receive Text Messages and Talk with an HIV counselor from the National HIV Hotline in Tanzania for Support with Linkage to Care Following HIV self-testing. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.01.24308312. [PMID: 38883795 PMCID: PMC11177922 DOI: 10.1101/2024.06.01.24308312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background Tanzania faces a significant burden of HIV, with particular challenges in reaching men and ensuring timely linkage to care. To address these issues, HIV self-testing (HIVST) has been implemented to increase HIV testing and the National HIV Hotlines are being considered as a strategy to facilitate linkage to care. This study aimed to assess the willingness of Tanzanian men to receive support from use the National HIV Hotline via mobile phones for HIVST and linkage to care. Methods Data from 505 men from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or "camps" in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. Logistic regression models were used to assess factors associated with men's comfort with talking with an HIV counselor over the phone. Results There were 505 heterosexual male participants enrolled in the study with an average age of 29 years. Logistic regression demonstrated that comfortability texting a friend about HIV self-testing (OR =3.37, 95% CI [1.97 - 5.76], being comfortable texting a friend about HIV (OR = 3.84, 95% CI [2.20 - 6.72], previous history of receiving HIV related text messages (aOR = 0.55, 95% CI [0.31 - 0.99] were significantly associated with men's s comfortability talking to a HIV counselor on the National HIV Hotline following HIVST. The factors such as participants' comfortability texting friend about HIVST (OR = 2.52, 95% CI [1.49 - 4.25]) and comfortability texting friend about HIV (OR = 2.96, 95% CI [1.83 - 4.80] were significantly associated with the probability of participant's comfortability receiving text message from HIV counselor following HIVST. Conclusion These findings suggest an effort to develop and implement a user-friendly digital health intervention that promote comfortability, address private concerns, and deliver tailored support and information to individuals following HIV self-testing.
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Affiliation(s)
- Frank Mhando
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
| | - Kelia Olughu
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Marwa Nyankomo
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
| | - James S. Ngocho
- Department of Epidemiology and Applied Biostatistics, Kilimanjaro Christian Medical University College, Moshi Tanzania
| | - Ivan Teri
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA
| | | | - BRIDGE Africa Team
- Building Research Implementation to Drive Growth and Equity (BRIDGE) Africa, Dar es Salaam, Tanzania
| | - Donaldson F. Conserve
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Mhando F, Nyankomo M, Hall C, Olughu K, Hlongwa M, Janson S, Idahosa LO, Hatcher G, Conserve DF. Digital Intervention Services to Promote HIV Self-Testing and Linkage to Care Services: A Bibliometric and Content Analysis-Global Trends and Future Directions. Public Health Rev 2024; 45:1606354. [PMID: 38434540 PMCID: PMC10904570 DOI: 10.3389/phrs.2024.1606354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Objective: The global burden of HIV remains a critical public health challenge, particularly in sub-Saharan Africa, home to over two-thirds of individuals living with HIV. HIV self-testing (HIVST) has emerged as a promising strategy endorsed by the World Health Organization to achieve UNAIDS targets. Despite its potential, challenges persist in linking self-testers to care post a positive result. Digital health interventions, including chatbots and mobile applications, offer innovative solutions to address this gap. However, a comprehensive bibliometric analysis of the collaboration and growth in the literature at the intersection of HIVST and digital interventions is lacking. Methods: The study employs a bibliometric approach, leveraging data from the Web of Science, to analyze the characteristics, citation pattern and content of 289 articles spanning 1992-2023. The analysis involves performance assessment, scientific collaboration analysis, science mapping, and content analysis. Key bibliometric indicators, such as annual growth rate, citation impact, and authorship patterns, are explored. Collaboration patterns among countries, institutions, and authors are elucidated, and thematic mapping provides insight into the key research themes. Results: The analysis reveals a dynamic and expanding field, with an annual scientific growth rate of 12.25%. Notable contributions come from diverse sources, including North America, Europe, and Africa. High-impact journals such as JMIR mHealth and uHealth play a crucial role in disseminating research findings. African authors, including Lebelonyane R, Ford N, and Lockman S, feature prominently, reflecting a positive trend in diverse authorship. Co-citation analysis highlights influential manuscripts, with systematic reviews dominating the top-cited articles. Collaboration analysis underscores strategic partnerships globally, particularly involving the United States, Australia, South Africa, and the United Kingdom. Conclusion: This bibliometrics analysis provides a comprehensive overview of the digital health landscape in HIVST and linkage to care. It identifies key contributors, high-impact journals, and collaborative networks. The thematic map reveals nuanced research domains, including alcohol dependence, men's health, outcomes, and user acceptance. The findings offer insights for researchers, policymakers, and practitioners, guiding future directions in the evolving intersection of HIVST and digital health interventions.
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Affiliation(s)
- Frank Mhando
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania
| | - Marwa Nyankomo
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
| | - Christa Hall
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Kelia Olughu
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Mbuzeleni Hlongwa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Public Health, Societies and Belonging, Human Sciences Research Council, Pretoria, South Africa
| | - Samuel Janson
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Love O. Idahosa
- Department of Economics, The University of Warwick, Coventry, United Kingdom
| | - Genae Hatcher
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Donaldson F. Conserve
- Johannesburg Business School, University of Johannesburg, Johannesburg, South Africa
- Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
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Matovu JKB, Kemigisha L, Taasi G, Musinguzi J, Wanyenze RK, Serwadda D. Secondary distribution of HIV self-test kits from males to their female sexual partners in two fishing communities in rural Uganda. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002477. [PMID: 38019783 PMCID: PMC10686447 DOI: 10.1371/journal.pgph.0002477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023]
Abstract
Secondary distribution of HIV self-test kits from females to their male partners has increased HIV testing rates in men but little evidence exists on the potential for HIV self-test kits distribution from males to their female partners. We assessed the acceptability of secondary HIV self-test kits distribution from males to their female sexual partners in a fishing community context. This secondary analysis used data from the PEer-led HIV Self-Testing intervention for MEN (PEST4MEN), a pilot interventional study in Buvuma and Kalangala districts in Uganda. At the baseline visit, in July 2022, data were collected from 400 men aged 15+ years who self-reported a HIV-negative or unknown HIV status. Enrolled men were asked to pick two oral fluid HIV self-test kits from a trained male distributor. At the first follow-up visit, in September 2022, men were asked about the number of kits that they received and if they gave kits to anyone, including to their female sexual partners. We used a modified Poisson regression model to determine the factors independently associated with giving kits to sexual partners. Data were analyzed using STATA version 16.0. Of 361 men interviewed at follow-up, 98.3% (355) received at least one kit; 79.7% (283) received two kits. Of those who received two kits, 64% (181) gave the second kit to anyone else; of these, 74.6% (132/177) gave it to a sexual partner. Being currently married (adjusted prevalence ratio [adj. PR] = 1.39; 95% confidence interval [95%CI]: 1.10, 1.75) and having difficulty in reading text prepared in the local language (adj. PR = 1.26; 95%CI: 1.03, 1.55) were significantly associated with men giving kits to their female sexual partners. Ninety-seven per cent (112/132) of the men reported that they knew their sexual partners' HIV self-test results. Of these, 93.7% (n = 105) reported that their partners were HIV-negative while 6.3% (n = 7) reported that they were HIV-positive. Only 28.6% (n = 2) of the HIV-positive sexual partners were reported to have initiated HIV care. Secondary distribution of HIV self-test kits from males to their female sexual partners is well accepted by women in the fishing communities, suggesting that distribution of kits through men in the fishing communities can help to improve HIV testing uptake among their female sexual partners.
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Affiliation(s)
- Joseph K. B. Matovu
- Busitema University Faculty of Health Sciences, Mbale, Uganda
- Makerere University School of Public Health, Kampala, Uganda
| | - Linda Kemigisha
- Makerere University School of Public Health, Kampala, Uganda
| | | | | | | | - David Serwadda
- Makerere University School of Public Health, Kampala, Uganda
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DiCarlo MC, Dallabetta GA, Akolo C, Bautista-Arredondo S, Digolo HV, Fonner VA, Kumwenda GJ, Mbulaje P, Mwangi PW, Persuad NE, Sikwese S, Wheeler TA, Wolf RC, Mahler HR. Adequate funding of comprehensive community-based programs for key populations needed now more than ever to reach and sustain HIV targets. J Int AIDS Soc 2022; 25:e25967. [PMID: 35880969 PMCID: PMC9318644 DOI: 10.1002/jia2.25967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/06/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Globally, over half of the estimated new HIV infections now occur among key populations, including men who have sex with men, sex workers, people who inject drugs, transgender individuals, and people in prisons and other closed settings, and their sexual partners. Reaching epidemic control will, for many countries, increasingly require intensified programming and targeted resource allocation to meet the needs of key populations and their sexual partners. However, insufficient funding, both in terms of overall amounts and the way the funding is spent, contributes to the systematic marginalization of key populations from needed HIV services. Discussion The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recently highlighted the urgent need to take action to end inequalities, including those faced by key populations, which have only been exacerbated by the COVID‐19 pandemic. To address these inequalities and improve health outcomes, key population programs must expand the use of a trusted access platform, scale up differentiated service delivery models tailored to the needs of key populations, rollout structural interventions and ensure service integration. These critical program elements are often considered “extras,” not necessities, and consequently costing studies of key population programs systematically underestimate the total and unitary costs of services for key populations. Findings from a recent costing study from the LINKAGES project suggest that adequate funding for these four program elements can yield benefits in program performance. Despite this and other evidence, the lack of data on the true costs of these elements and the costs of failing to provide them prevents sufficient investment in these critical elements. Conclusions As nations strive to reach the 2030 UNAIDS goals, donors, governments and implementers should reconsider the true, but often hidden costs in future healthcare dollars and in lives if they fail to invest in the community‐based and community‐driven key population programs that address structural inequities. Supporting these efforts contributes to closing the remaining gaps in the 95‐95‐95 goals. The financial and opportunity cost of perpetuating inequities and missing those who must be reached in the last mile of HIV epidemic control must be considered.
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Affiliation(s)
- Meghan C DiCarlo
- Global Health Population and Nutrition, FHI 360, Washington, DC, USA
| | | | - Chris Akolo
- Global Health Population and Nutrition, FHI 360, Washington, DC, USA
| | - Sergio Bautista-Arredondo
- Division of Health Economics and Health Systems Innovations, National Institute of Public Health (INSP), Cuernavaca, Mexico
| | | | - Virginia A Fonner
- Global Health Population and Nutrition, FHI 360, Washington, DC, USA
| | - Grace Jill Kumwenda
- Pakachere Institute for Health and Development Communication, Blantyre, Malawi
| | | | - Peninah W Mwangi
- Bar Hostess Empowerment and Support Program (BHESP), Nairobi, Kenya
| | | | - Simon Sikwese
- Pakachere Institute for Health and Development Communication, Blantyre, Malawi
| | - Tisha A Wheeler
- Office of HIV/AIDS, United States Agency for International Development (USAID), Washington, DC, USA
| | - R Cameron Wolf
- Office of HIV/AIDS, United States Agency for International Development (USAID), Washington, DC, USA
| | - Hally R Mahler
- Global Health Population and Nutrition, FHI 360, Washington, DC, USA
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