1
|
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 Glob 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
2
|
Ombere SO, Nyambedha EO. Non-adherence to antiretroviral treatment among migrating fishermen in western Kenya's islands: a rapid qualitative study. Afr J AIDS Res 2023; 22:237-243. [PMID: 38015894 DOI: 10.2989/16085906.2023.2276375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/01/2023] [Indexed: 11/30/2023]
Abstract
Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. The association of migration with HIV and AIDS in sub-Saharan Africa is well documented. Frequent mobility, high consumption of alcohol, multiple sexual partners, transactional and commercial sex, poor health infrastructure and limited access to health services are reported among the main factors shaping the HIV epidemic in fishing communities. Moreover, studies have been conducted in sub-Saharan Africa on adherence to antiretroviral treatment (ART) among fishers; however, non-adherence to ART remains poorly understood among migrating fishermen in the western Kenya islands. This qualitative study investigated factors contributing to non-adherence among fishermen in the western Kenya islands. This study utilised 51 in-depth interviews and six focus group discussions to highlight factors contributing to non-adherence to ART by mobile fishermen. Data were analysed using a contextualised thematic analysis. Results show that migration, alcohol consumption and ART sharing contributed to non-adherence. Adherence to ART is a powerful predictor of survival for individuals living with HIV and AIDS. The Kenyan government can use lessons from this study to target fishermen to achieve the UNAIDS 2025 recommendations on people-centred and context-specific service responses to AIDS as this would move Kenya closer to the 90% reduction in annual infections by 2030. This article contributes to a deeper understanding of how and why fishermen from the islands in western Kenya struggle to adhere to treatment even though they can access ARTs through the public health care system. Longitudinal studies should be conducted to explore how the factors associated with non-adherence correlate with other key health outcomes such as drug resistance.
Collapse
Affiliation(s)
- Stephen Okumu Ombere
- Centre for the Advancement of Scholarships, University of Pretoria, South Africa
- Department of Sociology and Anthropology, Maseno University, Kenya
| | | |
Collapse
|
3
|
Okello E, Ayieko P, Kwena Z, Nanyonjo G, Bahemuka U, Price M, Bukusi E, Hashim R, Nakamanya S, Okech B, Kuteesa M, Oketch B, Ssetaala A, Ruzagira E, Kidega W, Fast P, Kibengo F, Grosskurth H, Seeley J, Kapiga S. Acceptability and applicability of biometric iris scanning for the identification and follow up of highly mobile research participants living in fishing communities along the shores of Lake Victoria in Kenya, Tanzania, and Uganda. Int J Med Inform 2023; 172:105018. [PMID: 36774907 DOI: 10.1016/j.ijmedinf.2023.105018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Recruitment and retention of participants in research studies conducted in fishing communities remain a challenge because of population mobility. Reliable and acceptable methods for identifying and tracking participants taking part in HIV prevention and treatment research are needed. The study aims to assess the acceptability, and technical feasibility of iris scans as a biometric identification method for research participants in fishing communities. METHODS This was a cross-sectional study conducted in eight fishing communities in Kenya, Tanzania, and Uganda, with follow-up after one month in a randomly selected subset of participants. All consenting participants had their iris scanned and then responded to the survey. RESULTS 1,199 participants were recruited. The median age was 33 [Interquartile range (IQR) 24-42] years; 56% were women. The overall acceptability of iris scanning was 99%, and the success rate was 98%. Eighty one percent (n = 949) had a successful scan on first attempt, 116 (10%) on second and 113 (9%) after more than two attempts. A month later, 30% (n = 341) of participants were followed up. The acceptability of repeat iris scanning was 99% (n = 340). All participants who accepted repeat iris scanning had successful scans, with 307 (90%) scans succeeding on first attempt; 25 (7%) on second attempt, and 8 (2%) after several attempts. The main reason for refusing iris scanning was fear of possible side effects of the scan on the eyes or body. CONCLUSION The acceptability and applicability of biometric iris scan as a technique for unique identification of research participants is high in fishing communities. However, successful use of the iris scanning technology in research will require education regarding the safety of the procedure.
Collapse
Affiliation(s)
- Elialilia Okello
- Mwanza Intervention Trials Unit, National Institute for Medical Research, P.O Box 11936, Mwanza, Tanzania.
| | - Philip Ayieko
- Mwanza Intervention Trials Unit, National Institute for Medical Research, P.O Box 11936, Mwanza, Tanzania; London School of Hygiene and Tropical Medicine London, United Kingdom
| | - Zachary Kwena
- Kenya Medical Research Institute, KEMRI, Kisumu, Kenya
| | | | - Ubaldo Bahemuka
- Medical Research Council/Uganda Virus Research Institute Uganda Research Unit & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Matt Price
- International AIDS Vaccine Initiative, NY, USA; Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | | | - Ramadhan Hashim
- Mwanza Intervention Trials Unit, National Institute for Medical Research, P.O Box 11936, Mwanza, Tanzania
| | - Sarah Nakamanya
- Medical Research Council/Uganda Virus Research Institute Uganda Research Unit & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | | | | | - Bertha Oketch
- Kenya Medical Research Institute, KEMRI, Kisumu, Kenya
| | | | - Eugene Ruzagira
- London School of Hygiene and Tropical Medicine London, United Kingdom; Medical Research Council/Uganda Virus Research Institute Uganda Research Unit & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | | | - Patricia Fast
- International AIDS Vaccine Initiative, NY, USA; Pediatric Infectious Diseases, School of Medicine, Stanford University, Palo Alto CA, USA
| | - Freddie Kibengo
- Medical Research Council/Uganda Virus Research Institute Uganda Research Unit & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Heiner Grosskurth
- Mwanza Intervention Trials Unit, National Institute for Medical Research, P.O Box 11936, Mwanza, Tanzania; London School of Hygiene and Tropical Medicine London, United Kingdom
| | - Janet Seeley
- London School of Hygiene and Tropical Medicine London, United Kingdom; Medical Research Council/Uganda Virus Research Institute Uganda Research Unit & London School of Hygiene and Tropical Medicine (MRC/UVRI & LSHTM) Uganda Research Unit, Entebbe, Uganda
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, National Institute for Medical Research, P.O Box 11936, Mwanza, Tanzania; London School of Hygiene and Tropical Medicine London, United Kingdom
| |
Collapse
|