Partner-Delivered HIV Self-Testing Can Up Linkage to Care

Partner-delivered HIV self-testing (HIVST) with financial incentives or reminders can increase the odds of male partners being linked to care or prevention, according to a study published online Jan. 2 in PLOS Medicine.

Augustine T. Choko, from the Malawi-Liverpool-Wellcome Clinical Research Program in Blantyre, and colleagues enrolled 2,349 women attending an antenatal care clinic (ANC) for the first time for their current pregnancy. Participants were randomly assigned to the standard of care (SOC, with clinical invitation to male partner) or to one of five intervention arms: providing women with two HIVST kits, providing two HIVST kits with a conditional fixed financial incentive of either $3 or $10, providing two HIVST kits and a 10 percent chance of winning $30 in a lottery, and providing two HIVST kits and a phone call reminder for male partners.

The researchers found that 17.4 percent of the partners of women in the SOC arm tested for HIV. The proportion was much higher in all intervention arms (87.0 to 95.4 percent). The proportion of partners who met the primary end point and were tested for HIV and linked to care or prevention within 28 days was significantly higher for those who received the HIVST + $3, HIVST + $10, and HIVST + a phone reminder versus those in the SOC arm (geometric mean, 40.9, 51.7, and 22.3, respectively, versus 13.0 percent; adjusted risk ratios, 3.01, 3.72, and 1.58, respectively).

"We show pronounced effects on testing without safety concerns from secondary distribution of HIVST kits," the authors write.

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