Developing Confirmatory HIV Testing and Linkage to Care Intervention Strategies for Men in Tanzania
As the field of HIV testing, which is crucial for HIV prevention and care, has evolved from facility-to community-based or at-home HIV self-testing (HIVST), there is a need for interventions that can also facilitate community-based linkage to care and antiretroviral therapy (ART) initiation for self-testers, especially men who receive HIVST kits from their female partners and may not want to visit a healthcare facility for follow-up services. Community-based confirmatory HIV testing to support ART initiation can address the current gaps for HIVST. In Tanzania, where 55% of men living with HIV were unaware of their HIV status in 2017, index HIVST implementation has been piloted within routine healthcare practices with funding from the United States Agency for International Development (USAID), with a focus on reaching male partners of female index clients who do not report for facility-based HIV testing. Index HIVST involves women living with HIV receiving multiple HIVST kits to distribute to their male partners as additional interventions to increase HIV testing among men with a higher chance of being HIV-positive and are unaware of their HIV status. However, not all men who received HIVST kits from their female partners during the USAID-funded HIVST project in Tanzania. The proposed project aims to use Intervention Mapping (IM), which is a multistep theory-based intervention development process (7), to develop the Self-Testing Education and Promotion+ (STEP+) intervention to support confirmatory HIV testing and linkage to care for male partners who self-test and receive a positive result at home. Findings from the proposed study may also inform the development and implementation of interventions for confirmatory HIV testing and linkage to care in other settings, including Washington D.C. where HIVST was rolled out by the DC Department of Health in 2020.