University of Hertfordshire

  • Carmen Logie
  • Moses Okumu
  • Daniel Kibuuka Musoke
  • Robert Hakiza
  • Isha Berry
  • Simon Mwima
  • Richard Lester
  • Peter Kyambadde
  • Uwase Mimy Kiera
  • Miranda Loutet
  • Stella Neema
  • Katie Newby
  • Clara McNamee
  • Stefan Baral
  • Tushirikiane Peer Navigators
  • Joshua Musinguzi
  • Lawrence Mbuagbaw
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Original languageEnglish
JournalJMIR research protocols
Publication statusAccepted/In press - 18 Dec 2020

Abstract

Background: HIV is the leading cause of mortality among youth in sub-Saharan Africa. Uganda hosts over 1.43 million refugees, and more than 83,000 live in Kampala, largely in informal settlements (‘slums’). There is limited information about HIV testing uptake and preferences among urban refugee youth, such as those living in Kampala. HIV self-testing (HIVST) is a promising method for increasing testing uptake and HIV status knowledge. Further, mobile-health (mHealth) interventions have been shown effective in increasing HIV testing uptake and could be particularly useful amongst youth. This study aims to evaluate the feasibility and clinical effectiveness of two HIVST delivery approaches (HIVST intervention alone, and an HIVST combined with mHealth intervention) in comparison with the standard of care, on HIV testing outcomes amongst refugee and displaced youth aged 16-24 years in Kampala, Uganda.
Methods: A three-arm cluster randomized controlled trial will be implemented across five informal settlements. Settlements are grouped into three sites, based on proximity, and randomized in a 1:1:1 method. Approximately 450 adolescents (150 in each cluster) will be enrolled and followed for twelve months. Data will be collected at three-time points: baseline enrollment, eight-months after enrollment, and twelve-months after enrollment. Primary outcomes (frequency of HIV testing, HIV status knowledge, linkage to confirmatory testing, and linkage to HIV care) and secondary outcomes (depression, condom use efficacy, consistent condom use, sexual relationship power, HIV stigma, and adolescent sexual and reproductive health stigma) will be evaluated.
Discussion: This study will contribute to the knowledge of differentiated HIV testing implementation strategies for urban refugee and displaced youth living in informal settlements. Community partners and knowledge users are involved in all stages of trial design, implementation, analysis, and dissemination. Should findings indicate effectiveness, these partnerships will facilitate the scale-up of this intervention.
Trial Registration: This trial is registered at ClinicalTrials.gov (NCT04504097).

ID: 24578953