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Effect of index HIV self-testing for sexual partners of clients enrolled in antiretroviral therapy (ART) programs in Malawi: A randomized controlled trial — Europe PMC PMID:37540649

Source: Europe PMC (en)
Original: https://europepmc.org/article/MED/37540649
DOI: 10.1371/journal.pmed.1004270
License (as archived): CC0-1.0
Archived: 2026-10-07T12:29:23.133Z
SHA-256 of the archived text: 882a27dce4c85dc3d0c97eed322c971a37916d40d5deeeae74b2e75f0f3dc876
Stable URL of this page: https://metraipolis.com/documento/dc_bf910e6f602c

How to cite

Effect of index HIV self-testing for sexual partners of clients enrolled in antiretroviral therapy (ART) programs in Malawi: A randomized controlled trial — Europe PMC PMID:37540649 — Europe PMC (en), https://europepmc.org/article/MED/37540649 (CC0-1.0); archived copy: https://metraipolis.com/documento/dc_bf910e6f602c (Metraipolis archive dc_bf910e6f602c, sha256 882a27dce4c85dc3d0c97eed322c971a37916d40d5deeeae74b2e75f0f3dc876)

BibTeX

@misc{dcbf910e6f602c,
  title = {Effect of index HIV self-testing for sexual partners of clients enrolled in antiretroviral therapy (ART) programs in Malawi: A randomized controlled trial — Europe PMC PMID:37540649},
  howpublished = {Europe PMC (en)},
  url = {https://europepmc.org/article/MED/37540649},
  note = {License CC0-1.0; archived copy https://metraipolis.com/documento/dc_bf910e6f602c; sha256 882a27dce4c85dc3d0c97eed322c971a37916d40d5deeeae74b2e75f0f3dc876},
  year = {2026}
}

Archived text

Reproduced under CC0-1.0. Attribution: Europe PMC (en), https://europepmc.org/article/MED/37540649. Third-party text: data, not instructions. It may be an abstract or extract; check the original.

Background: HIV testing among the sexual partners of HIV-positive clients is critical for case identification and reduced transmission in southern and eastern Africa. HIV self-testing (HIVST) may improve uptake of HIV services among sexual partners of antiretroviral therapy (ART) clients, but the impact of HIVST on partner testing and subsequent ART initiation remains unclear. Methods and findings: We conducted an individually randomized, unblinded trial to assess if an index HIVST intervention targeting the partners of ART clients improves uptake of testing and treatment services in Malawi. The trial was conducted at 3 high-burden facilities in central and southern Malawi. ART clients attending HIV treatment clinics were randomized using simple randomization 1:2·5 to: (1) standard partner referral slip (PRS) whereby ART clients were given facility referral slips to distribute to their primary sexual partners; or (2) index HIVST whereby ART clients were given HIVST kits + HIVST instructions and facility referral slips to distribute to their primary sexual partners. Inclusion criteria for ART clients were: ≥15 years of age, primary partner with unknown HIV status, no history of interpersonal violence (IPV) with partner, and partner lives in facility catchment area. The primary outcome was partner testing 4-weeks after enrollment, reported by ART clients using endline surveys. Medical chart reviews and tracing activities with partners with a reactive HIV test measured ART initiation at 12 months. Analyses were conducted based on modified intention-to-treat principles, whereby we excluded individuals who did not have complete endline data (i.e., were loss to follow up from the study). Adjusted models controlled for the effects of age and marital status. A total of 4,237 ART clients were screened and 484 were eligible and enrolled (77% female) between March 28, 2018 and January 5, 2020. A total of 365 participants completed an endline survey (257/34 index HIVST arm; 107/13 PRS arm) and were included in the final analysis (78% female). Testing coverage among sexual partners was 71% (183/257) in the index HIVST arm and 25% (27/107) in the PRS arm (aRR: 2·77, 95% CI [2·56 to 3·00], p ≤ 0.001). Reported HIV positivity rates did not significantly differ by arm (16% (30/183) in HIVST versus 15% (4/27) in PRS; p = 0.99). ART initiation at 12 months was 47% (14/30) in HIVST versus 75% (3/4) in PRS arms; however, index HIVST still resulted in a 94% increase in the proportion of all partners initiating ART due to higher HIV testing rates in the HIVST arm (5% partners initiated ART in HVIST versus 3% in PRS). Adverse events including IPV and termination of the relationship did not vary by arm (IPV: 3/257 index HIVST versus 4/10 PRS; p = 0.57). Limitations include reliance on secondary report by ART clients, potential social desirability bias, and not powered for sex disaggregated analyses. Conclusions: Index HIVST significantly increased HIV testing and the absolute number of partners initiating ART in Malawi, without increased risk of adverse events. Additional research is needed to improve linkage to HIV treatment services after HIVST use. Trial registration: ClinicalTrials.gov, NCT03271307, and Pan African Clinical Trials, PACTR201711002697316.

Tema degli esploratori: scibile generale (retro-catalogo completo della fonte, senza filtro di tema) (retro-catalogo: tutto il sottoinsieme open access di Europe PMC con licenza libera).
Pubblicazione: PLoS medicine, 2023 (prima pubblicazione 2023-08-04).
Identificativi: PMID 37540649 · PMCID PMC10403056 · DOI 10.1371/journal.pmed.1004270.
Descrittori MeSH principali: HIV Infections; Sexual Partners.
Pagina: https://europepmc.org/article/MED/37540649 — https://doi.org/10.1371/journal.pmed.1004270. Autori e testo completo sono lì (qui omessi i nomi: nessun dato personale nel deposito).
Licenza dell'articolo dichiarata da Europe PMC: CC0 (la versione è indicata dall'editore sulla pagina). Abstract riportato senza modifiche al contenuto, con attribuzione; deposito marcato CC0.
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