Feasibility and acceptability of peer-delivered HIV and syphilis self-test kits and assisted partner notification services for gay, bisexual and other men who have sex with men: a qualitative study in Uganda

J Int AIDS Soc. 2025 May;28(5):e26456. doi: 10.1002/jia2.26456.

ABSTRACT

INTRODUCTION: There is a need to combine different approaches to tackle the HIV epidemic, particularly in high-incidence populations. We explored the feasibility and acceptability of using peer-delivered HIV self-testing (HIVST), syphilis self-testing (SST) and assisted partner notification (APN) services among gay, bisexual and other men who have sex with men (GBMSM) in Uganda.

METHODS: From November 2023 to March 2024, we conducted in-depth interviews with 20 purposively selected GBMSM peers and 10 healthcare workers (HCWs). The GBMSM and HCWs interviews explored their perspectives on (1) the feasibility, acceptability and preferences for peer-delivered interventions (HIVST, SST and APN) and (2) strategies and methods of reaching individuals who had not been tested or tested more than 6 months before the interview. We used a content analysis approach to define and organize codes deductively and inductively to identify themes.

RESULTS: The median age of the 20 GBMSM peers was 27 years (interquartile range [IQR], 22-35 years), and 37 years (IQR, 25-52) for the 10 HCWs, of whom seven were female. We identified four emerging categories: (1) Trust: GBMSM peers and HCWs expressed trust in the peer delivery of self-test kits (HIVST and SST) to obtain same-day results effectively. HCWs were preferred over peers for APN services in reaching sexual contacts of index clients for testing; (2) Intimate partner violence (IPV): Although initial concerns about IPV were raised concerning both HIVST programmes and peer APN strategies, such incidents were rarely reported in practice; (3) Entry point: Similar to HIVST, SST was a self-administered activity that served as an entry point for HIV testing discussions among GBMSM who had either never undergone or had postponed testing. Self-test kits could also facilitate pre-sexual testing among GBMSM; (4) Social media: Campaigns on social media dedicated to promoting self-testing could expand testing coverage services to GBMSM vulnerable to HIV and syphilis acquisition.

CONCLUSIONS: HCWs and GBMSM peers preferred delivery of self-test kits through peers over facility-based approaches; however, they favoured HCWs for providing APN services. Integrating peer-delivered self-testing programmes into differentiated testing models and leveraging social media influencers could expand testing coverage among GBMSM.

PMID:40390332 | DOI:10.1002/jia2.26456