Men’s Comfort to Distribute or Receive HIV Self-Test Kits from Close Male Social Network Members in Tanzania: Baseline Results from the STEP Project

Abstract Background Few studies have explored alternative strategies for reaching men with HIV self-testing services. In this study, we assessed the factors associated with men’s comfort to distribute or receive HIV self-test kits from close male friends among men who socialize in networks locally referred to as "camps" in Tanzania. Methods Data are from a cluster-randomized controlled trial conducted in June 2019 in 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. Robust Poisson regression was implemented through the generalized random effect model with the log link to assess the factors associated with being comfortable to receive and/or give out HIV self-test kits to close male members within one’s social network. Results Of 505 participants, 67.9% (n = 342) reported that they would be comfortable giving HIV self-test kits to close male friends while 68.2% (n = 344) were comfortable receiving HIV self-test kits from their close male friends. Ever having heard about HIV self-testing (Adjusted Prevalence Rate (Adj. PR): 1.6; 95% Confidence Interval [CI]: 1.3, 1.9), willingness to self-test for HIV in front of a sexual partner (Adj. PR: 3.0; 95%CI: 1.5, 6.1) and exposure to peer-led HIV self-testing education and promotion (Adj. PR: 1.4; 95%CI: 1.2, 1.7) were significantly associated with being comfortable to receive and/or give out HIV self-test kits to close male members within one’s social network. Conclusions Prior awareness of HIV self-testing, willingness to self-test before one’s sexual partner and exposure to peer-led HIV self-testing education and promotion were significantly associated with being comfortable to give or receive HIV self-test kits from close male friends in this population. These findings suggest that distribution of HIV self-test kits through close male friends could improve the proportion of men reached with HIV self-testing services and improve HIV testing rates in this population where uptake remains low.