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Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial

INTRODUCTION: Secondary distribution of HIV self‐tests (HIVST) by HIV‐negative pregnant women to male partners increases men's testing rates. We examined whether this strategy promotes male partner testing for pregnant women living with HIV (PWLHIV). METHODS: We conducted an open‐label individu...

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Autores principales: Mujugira, Andrew, Nakyanzi, Agnes, Donnell, Deborah, Boyer, Jade, Stein, Gabrielle, Bulterys, Michelle, Naddunga, Faith, Kyomugisha, Juliet, Birungi, Juliet E., Ssendiwala, Paul, Nsubuga, Rogers, Muwonge, Timothy R., Musinguzi, Joshua, Sharma, Monisha, Celum, Connie L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483500/
https://www.ncbi.nlm.nih.gov/pubmed/37675834
http://dx.doi.org/10.1002/jia2.26156
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author Mujugira, Andrew
Nakyanzi, Agnes
Donnell, Deborah
Boyer, Jade
Stein, Gabrielle
Bulterys, Michelle
Naddunga, Faith
Kyomugisha, Juliet
Birungi, Juliet E.
Ssendiwala, Paul
Nsubuga, Rogers
Muwonge, Timothy R.
Musinguzi, Joshua
Sharma, Monisha
Celum, Connie L.
author_facet Mujugira, Andrew
Nakyanzi, Agnes
Donnell, Deborah
Boyer, Jade
Stein, Gabrielle
Bulterys, Michelle
Naddunga, Faith
Kyomugisha, Juliet
Birungi, Juliet E.
Ssendiwala, Paul
Nsubuga, Rogers
Muwonge, Timothy R.
Musinguzi, Joshua
Sharma, Monisha
Celum, Connie L.
author_sort Mujugira, Andrew
collection PubMed
description INTRODUCTION: Secondary distribution of HIV self‐tests (HIVST) by HIV‐negative pregnant women to male partners increases men's testing rates. We examined whether this strategy promotes male partner testing for pregnant women living with HIV (PWLHIV). METHODS: We conducted an open‐label individually randomized trial in Kampala, Uganda, in which PWLHIV ≥18 years who reported a partner of unknown HIV status were randomized 2:1 to secondary distribution of HIVST for male partner(s) or standard‐of‐care (SOC; invitation letter to male partner for fast‐track testing). Women were followed until 12 months post‐partum. Male partners were offered confirmatory HIV testing and facilitated linkage to antiretroviral treatment (ART) or oral pre‐exposure prophylaxis (PrEP). Using intention‐to‐treat analysis, primary outcomes were male partner testing at the clinic and initiation on PrEP or ART evaluated through 12 months post‐partum (ClinicalTrials.gov, NCT03484533). RESULTS: From November 2018 to March 2020, 500 PWLHIV were enrolled with a median age of 27 years (interquartile range [IQR] 23–30); 332 were randomized to HIVST and 168 to SOC with 437 PWLHIV (87.4%) completing 12 months follow‐up post‐partum. Of 236 male partners who tested at the clinic and enrolled (47.2%), their median age was 31 years (IQR 27–36), 45 (88.3%) men with HIV started ART and 113 (61.1%) HIV‐negative men started PrEP. There was no intervention effect on male partner testing (hazard ratio [HR] 1.04; 95% confidence interval [CI]: 0.79–1.37) or time to ART or PrEP initiation (HR 0.96; 95% CI: 0.69–1.33). Two male partners and two infants acquired HIV for an incidence of 0.99 per 100 person‐years (95% CI: 0.12–3.58) and 1.46 per 100 person‐years (95% CI: 0.18%–5.28%), respectively. Social harms related to study participation were experienced by six women (HIVST = 5, SOC = 1). CONCLUSIONS: Almost half of the partners of Ugandan PWLHIV tested for HIV with similar HIV testing rates and linkage to ART or PrEP among the secondary distribution of HIVST and SOC arms. Although half of men became aware of their HIV serostatus and linked to services, additional strategies to reach male partners of women in antenatal care are needed to increase HIV testing and linkage to services among men.
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spelling pubmed-104835002023-09-08 Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial Mujugira, Andrew Nakyanzi, Agnes Donnell, Deborah Boyer, Jade Stein, Gabrielle Bulterys, Michelle Naddunga, Faith Kyomugisha, Juliet Birungi, Juliet E. Ssendiwala, Paul Nsubuga, Rogers Muwonge, Timothy R. Musinguzi, Joshua Sharma, Monisha Celum, Connie L. J Int AIDS Soc Research Articles INTRODUCTION: Secondary distribution of HIV self‐tests (HIVST) by HIV‐negative pregnant women to male partners increases men's testing rates. We examined whether this strategy promotes male partner testing for pregnant women living with HIV (PWLHIV). METHODS: We conducted an open‐label individually randomized trial in Kampala, Uganda, in which PWLHIV ≥18 years who reported a partner of unknown HIV status were randomized 2:1 to secondary distribution of HIVST for male partner(s) or standard‐of‐care (SOC; invitation letter to male partner for fast‐track testing). Women were followed until 12 months post‐partum. Male partners were offered confirmatory HIV testing and facilitated linkage to antiretroviral treatment (ART) or oral pre‐exposure prophylaxis (PrEP). Using intention‐to‐treat analysis, primary outcomes were male partner testing at the clinic and initiation on PrEP or ART evaluated through 12 months post‐partum (ClinicalTrials.gov, NCT03484533). RESULTS: From November 2018 to March 2020, 500 PWLHIV were enrolled with a median age of 27 years (interquartile range [IQR] 23–30); 332 were randomized to HIVST and 168 to SOC with 437 PWLHIV (87.4%) completing 12 months follow‐up post‐partum. Of 236 male partners who tested at the clinic and enrolled (47.2%), their median age was 31 years (IQR 27–36), 45 (88.3%) men with HIV started ART and 113 (61.1%) HIV‐negative men started PrEP. There was no intervention effect on male partner testing (hazard ratio [HR] 1.04; 95% confidence interval [CI]: 0.79–1.37) or time to ART or PrEP initiation (HR 0.96; 95% CI: 0.69–1.33). Two male partners and two infants acquired HIV for an incidence of 0.99 per 100 person‐years (95% CI: 0.12–3.58) and 1.46 per 100 person‐years (95% CI: 0.18%–5.28%), respectively. Social harms related to study participation were experienced by six women (HIVST = 5, SOC = 1). CONCLUSIONS: Almost half of the partners of Ugandan PWLHIV tested for HIV with similar HIV testing rates and linkage to ART or PrEP among the secondary distribution of HIVST and SOC arms. Although half of men became aware of their HIV serostatus and linked to services, additional strategies to reach male partners of women in antenatal care are needed to increase HIV testing and linkage to services among men. John Wiley and Sons Inc. 2023-09-07 /pmc/articles/PMC10483500/ /pubmed/37675834 http://dx.doi.org/10.1002/jia2.26156 Text en © 2023 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Mujugira, Andrew
Nakyanzi, Agnes
Donnell, Deborah
Boyer, Jade
Stein, Gabrielle
Bulterys, Michelle
Naddunga, Faith
Kyomugisha, Juliet
Birungi, Juliet E.
Ssendiwala, Paul
Nsubuga, Rogers
Muwonge, Timothy R.
Musinguzi, Joshua
Sharma, Monisha
Celum, Connie L.
Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial
title Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial
title_full Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial
title_fullStr Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial
title_full_unstemmed Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial
title_short Partner testing with HIV self‐test distribution by Ugandan pregnant women living with HIV: a randomized trial
title_sort partner testing with hiv self‐test distribution by ugandan pregnant women living with hiv: a randomized trial
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483500/
https://www.ncbi.nlm.nih.gov/pubmed/37675834
http://dx.doi.org/10.1002/jia2.26156
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