Adaptation of a Health Education Program for Improving the Uptake of HIV Self-Testing by Men in Rwanda: A Study Protocol
Abstract
:Contributions to the Literature
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- Policy development for the implementation of HIV self-testing varies from country to country, indicating that the implementation strategies would differ accordingly.
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- The current study will utilize a pragmatic approach to adapt and optimize a health education program that may be applicable to the local context but also proffer solutions for similar low- to middle-income country (LMIC) settings.
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- Currently, there is a paucity of evidence on health education programs (HEPs) targeted for men specifically for HIV self-testing uptake.
1. Background
1.1. Ethical Considerations
1.2. Trial Registration
2. Methods
2.1. Study Design
2.2. Theoretical Framework
2.3. Study Setting
2.4. Phase 1: Scoping Review
2.5. Phase 2: Qualitative Study
2.6. Phase 3: Cross Sectional Survey
2.6.1. Objective 3: To assess HIVST Awareness among Men in Kigali, Rwanda
2.6.2. Objective 4: To develop and Optimize an HEP for Improving the Uptake of HIVST among Men in Rwanda
2.7. Recruitment Strategy
2.8. Inclusion Criteria
2.9. Phase 4: Pilot Randomized-Controlled Trial
- is an adult man 18 years and older;
- does not know his HIV status;
- is visiting the study-selected health facility during the enrollment period
- is willing to be followed up three months post-enrollment.
3. Data Security
4. Discussion
Availability of Data and Materials
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
CFIR | The Consolidated Framework for Implementation Research |
HEP | health education program |
HIVST | HIV self-testing |
HTS | HIV testing service |
LMICs | low- and middle-income countries |
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Intervention Characteristics |
---|
(a) Intervention source: Perception of key stakeholders about whether HIVST externally or internally developed. |
(b) Evidence Strength and Quality: Stakeholders’ perceptions of the quality and validity of evidence supporting the belief that HIVST will have desired outcomes. |
(c) Relative advantage: Stakeholders’ perception of the advantage of implementing HIVST versus an alternative solution |
(d) Adaptability: The degree to which HIVST can be adapted, tailored, refined, or reinvented to meet local needs |
(e) Trialability: The ability to test HIVST on a small scale in the organization, and to be able to reverse course (undo implementation) if warranted. |
(f) Complexity Perceived difficulty of implementation, reflected by duration, scope, radicalness, disruptiveness, centrality, and intricacy and number of steps required to implement |
(g) Design Quality and Packaging Perceived excellence in how HIVST bundled, presented, and assembled |
(h) Cost: Costs of HIVST and costs associated with implementing HIVST including investment, supply, and opportunity costs. |
Study Site | Number of Monthly Male Clinic Attendees Per Month | Calculated Sample Size for Study Site (Probability Proportionate to Size) | Systematic Random Sampling Strategy |
---|---|---|---|
1 | 400 | (400/900 × 384) 170 | (900/400) every 2nd person |
2 | 300 | (300/900 × 384) 128 | (900/300) every 3rd person |
3 | 200 | (200/900 × 384) 86 | (900/200) every 5th person |
Totals | 900 | 384 |
Outcome Measures Variable | Criteria for Success/Hypothesis | Exploratory Factors | Methods of Analysis |
---|---|---|---|
Phase 1: Objective 1 To conduct a scoping review on health education programs (HEPs) for men in low- and middle-income countries (LMICs) | |||
Improved availability, acceptability, and uptake of health education programs (HEPs) by men in low- and middle-income countries (LMICs). | N/A | Availability, acceptability, and uptake of HEPs. | Thematic content analysis Number studies of reporting outcomes of interest. |
Phase 2: Objective 2 To determine key stakeholder and health care providers’ perceptions on implementation of HIVST in Rwanda | |||
Perception | N/A | Key stakeholders and health care provider’s perceptions on the implementation of HIV-self testing | Qualitative Thematic content analysis |
Phase 3: Objective 3 To assess HIVST awareness among men in Rwanda | |||
Awareness | N/A | Demographic characteristics, knowledge, attitudes, HIV risk perception, and health seeking behavior characteristics | Descriptive statistics or estimates based on 95% confidence intervals (CI) Logistic regression |
Acceptability | |||
Objective 4 To develop and optimize an HEP for improving uptake of HIVST among men in Rwanda | |||
Adapted HEP | N/A | N/A | Nominal group technique |
Phase 4: Objective 5 To determine preliminary impact of the HEP on uptake of HIVST among men in Rwanda | |||
|
|
| Descriptive statistics or estimates based on 95% confidence intervals (CI) |
% of men who get HIV diagnosis | Higher proportion of HIV diagnosis, linkage to care, and repeat testing for negative participants in the intervention group (HEP), compared with the non-intervention group. | Age, education level, religious belief, sexual behavior, sexual preference, marital status; age of first sexual encounter; the number of sexual partners, the history of STI, circumcision, condom use, alcohol and drug use, perceived risk of contracting HIV, level of income, distance to the point of sale of HIVST | Logistic regression |
% of men who tested HIV positive and linked to care | |||
% of repeat test from men who tested HIV negative |
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Dzinamarira, T.; Mashamba-Thompson, T.P. Adaptation of a Health Education Program for Improving the Uptake of HIV Self-Testing by Men in Rwanda: A Study Protocol. Medicina 2020, 56, 149. https://doi.org/10.3390/medicina56040149
Dzinamarira T, Mashamba-Thompson TP. Adaptation of a Health Education Program for Improving the Uptake of HIV Self-Testing by Men in Rwanda: A Study Protocol. Medicina. 2020; 56(4):149. https://doi.org/10.3390/medicina56040149
Chicago/Turabian StyleDzinamarira, Tafadzwa, and Tivani Phosa Mashamba-Thompson. 2020. "Adaptation of a Health Education Program for Improving the Uptake of HIV Self-Testing by Men in Rwanda: A Study Protocol" Medicina 56, no. 4: 149. https://doi.org/10.3390/medicina56040149