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Increase HIV Testing Among Truck Drivers and Female Sex Workers in Kenya Through Offering HIV Self-Testing

Not Applicable
Completed
Conditions
HIV Testing
Interventions
Behavioral: Intervention
Behavioral: Enhanced Standard of Care
Behavioral: Traditional Standard of Care
Registration Number
NCT03662165
Lead Sponsor
City University of New York, School of Public Health
Brief Summary

The study aimed to assess whether advertising the availability of self-administered oral HIV testing kits increases the number of truck drivers and female sex workers who come to the North Star Alliance clinics for HIV testing (Demand creation). The investigators sent text messages to eligible truck drivers and female sex workers registered in the North Star Alliance electronic health record system who, based on those records, were not accessing HIV testing regularly and randomized them to receive one of two messaged, (1) the standard message sent to all clients who have not tested for HIV in the past 3 months reminding them of the availability of HIV testing at North Star clinics or (2) a text message announcing the availability of HIV self-testing kits fat all North Star clinics in Kenya. The investigators then compared the number of truck drivers and female sex workers from our samples who came to the clinic for HIV testing over a 2 month period following the first text message in the two study arms.

Detailed Description

The study aimed to assess whether advertising the availability of self-administered oral HIV testing kits increases the number of truck drivers and female sex workers who come to the North Star Alliance clinics for HIV testing (Demand creation). The investigators first selected a sample of eligible truck drivers from the electronic health record system of the North Star Alliance who, based on those records, were not accessing HIV testing regularly, sent passive text messages alerting them that The North Star Alliance was planning to use their deidentified electronic health data for program evaluation purposes and gave them the option to opt out of being included. The investigators then randomized those who did not opt-out on a 1:1:1 ratio to receive one of two messages, (1) the standard (SOC) message sent to all clients who have not tested for HIV in the past 3 months reminding them of the availability of HIV testing at North Star clinics sent one time (2) the SOC message sent three times, a week apart (Enhanced SOC) or (2) a text message announcing the availability of HIV self-testing kits fat all North Star clinics in Kenya sent three times, a week apart. The investigators compared the number of truck drivers from our sample who came to the clinic for HIV testing over a 2 month period following the first text message in the three study arms. After completing the study among truck drivers, we followed the same procedures for a sample of female sex workers registered in the electronic health record system who were not accessing HIV testing regularly.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
4458
Inclusion Criteria
  • Truck Drivers or Trucking Assistants (Sample 1) and female sex workers(Sample 2) registered in the North Star Alliance electronic health record system and who
  • had no indication that they were HIV-positive
  • resided in Kenya
  • had a valid mobile phone number listed
  • had fewer than four HIV tests recorded in the system in the past 12 months (indicating that they were not following the recommendation to test every 3 months for 4 tests per year), and
  • had not had an HIV test in the past 3 months.
Exclusion Criteria
  • None

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionInterventionThe primary intervention consisted of a text message informing participants that HIV self-test kits were available at all North Star Alliance clinics in Kenya. The message was sent three times, one week apart, first in Kiswahili, then in English and then again in Kiswahili, and read: "You can now self-test at home or in the clinic for HIV using a new test kit available from all North Star Alliance clinics in Kenya. Your health, our priority."
Enhanced Standard of CareEnhanced Standard of CareThose randomized to the enhanced Standard of Care (SOC) arm received the SOC message reminding clients about HIV testing sent three times, one week apart first in Kiswahili, then in English and then again in Kiswahili. The message read: "North Star Alliance East Africa would wish to kindly remind you to visit any of our roadside wellness centres for HIV testing. Your health, our priority."
Traditional Standard of CareTraditional Standard of CareThose randomized to the traditional SOC arm received the SOC message one time sent simultaneously in both Kiswahili and English. The message read: "North Star Alliance East Africa would wish to kindly remind you to visit any of our roadside wellness centres for HIV testing. Your health, our priority."
Primary Outcome Measures
NameTimeMethod
The Proportion who tested for HIV over 2 months follow-up2 months following the first text message

We compared the proportion who tested for HIV during the 2-month follow-up period among participants in the Intervention arm versus those in the Enhanced Standard of Care (SOC) arm (primary comparison) as well as among those in the Enhanced SOC versus those in the Traditional SOC arms (secondary comparison) to look at the impact of the content of the text message (i.e. about self-testing kits or HIV testing in general) and of the number of text messages (3 versus 1) on HIV testing, respectively.

Secondary Outcome Measures
NameTimeMethod
Effect Modification of HIV testing outcome by HIV testing history (Had an HIV test in the past year or not)2 months

We also looked at whether the differences in HIV testing by study arm were modified by HIV testing history (whether the client had an HIV test at a North Star Alliance clinic in the past year).

Proportion who had any clinic contact over the 2 month follow-up2 months

We also looked at differences in clinic contact for any reason (i.e., for HIV testing or some other service) between the three groups to see if the text messages brought more clients to the clinic even if some chose not to test for HIV.

Trial Locations

Locations (1)

CUNY Graduate School of Public Health and Health Policy

🇺🇸

New York, New York, United States

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