Using a 360 Communication Channel Mix to Increase Uptake of Ora Quick HIV Self Testing Kits Among Key Populations in Uganda.

Summary:

In Uganda the Ministry of Health (MOH) has adopted the 90-90-90 targets for its HIV treatment program. National coverage of HIV testing by HIV-positive individuals, the first 90, stands at 87%. Several behavioral barriers still affect uptake of HIV testing services (HTS) among different target audiences. These include lack of time to seek out testing services, and fear of test results. In 2016, the MOH updated its consolidated HIV guidelines and included HIV self-testing (HIVST) using OraQuick as one intervention to improve HTS uptake. USAID/Communication for Healthy Communities (USAID/CHC) was tasked with designing health communication interventions to increase demand for HIVST. Working with Implementing Partners (IP), USAID/CHC developed print, audio and visual materials, such as job aids, and videos to increase knowledge and create demand for HIVST and address other barriers to HIV testing. Health workers and community champions were oriented to conduct targeted mobilization through interpersonal communication (IPC). Exposure to self-testing messages improved knowledge, self-efficacy and motivation among the audiences to demand for self-testing services. Between September 2018 and April 2019, over 112 calls were received by the MoH hotline inquiring about HIVST. Of these, 60% were women and 40% men. Of these, 21% called to learn how to use the kit, 11% sought information on where to find the kits, 48% inquired about how to interpret results. Using multiple channels of communication to reach audiences proved effective because it promoted reach, intensity, and saturation of the messages to the intended audiences.

Background/Objectives

In Uganda the Ministry of Health (MOH) has adopted the 90-90-90 targets for its HIV treatment program. National coverage of HIV testing by HIV-positive individuals, the first 90, stands at 87%. The MOH has proposed that the first 95 will be achieved by 2020. Several behavioral barriers still affect uptake of HIV testing services (HTS) among different target audiences. These include lack of time to seek out testing services, low HIV risk perception, fear of test results, negative perceptions of providers. Therefore, new innovative approaches are needed to reach the remaining HIV-positive individuals who do not know their status.

Description Of Intervention And/or Methods/Design

In 2016, the MOH updated its consolidated HIV guidelines and included HIV self-testing (HIVST) using OraQuick as one intervention to improve HTS uptake. USAID/CHC was tasked with designing health communication interventions to increase demand for HIVST among target audiences. Working with Implementing Partners (IP), USAID/CHC developed print, audio and visual materials, such as job aids, brochures, and videos to increase knowledge and create demand for HIVST as well as address other barriers to HIV testing. USAID/CHC also worked with IPs to orient health workers and community champions to conduct targeted mobilization through interpersonal communication (IPC). IPC was supplemented by other channels such as social media and mass media and a hotline was offered to respond to questions on HIVST

Results/Lessons Learned

Exposure to self-testing messages was significantly associated to demand for HIV self-testing services, through the different channelsду» over 10,000 people were exposed to the messages. This exposure improved knowledge, self-efficacy and motivation among the intended audiences to demand for self-testing services.

Between September 2018 and April 2019, over 112 calls were received by the MoH hotline inquiring about HIVST. Of these, 60% were women and 40% men. Of these, 21% called to learn how to use the kit, 11% sought information on where to find the kits, 48% inquired about how to interpret results. Another 15% called with general inquiries about self-testing.
 Between October 2018 to March 2019, 8,685 self-kits were distributed among different target audiences such as Female Sex Workers, People Who use Injectable Drugs. 179 (2.1%) reported an HIV positive result and out of those 122 were confirmed HIV-positive using the national testing algorithm (MoH HMIS 2019).

Discussion/Implications For The Field

Using multiple channels of communication to reach audiences proved effective because it promoted reach, intensity, and saturation of the messages to the intended audiences. Mass media was re-enforced by IPC and this channel mix led broader discussions demystifying the barriers to HIV self-testing. 
 The call center number provided on the materials designed was vital for people to ask any questions at the comfort of their homes maintaining peopleду»s confidentiality and freedom.

Abstract submitted by:

Brian Asiimwe - FHI 360

EDITH NANTONGO

Armstrong Mukundane - FHI 360