Trial of Expanded Social Network Recruitment to Increase HIV Testing, Find Undiagnosed HIV Cases, and Reduce Stigma in KwaZulu-Natal, South Africa

What this Trial Is About

Researchers are evaluating an expanded social network recruitment to HIV testing E-SNRHT intervention in South Africa to address the challenge of locating undiagnosed HIV cases and reducing HIV-related stigma. This study focuses on increasing HIV testing among men, who are less likely to seek testing, by encouraging peer recruitment beyond risk partners to include any social contacts. The study is a site-randomized trial involving 32 Department of Health clinics in KwaZulu-Natal, comparing E-SNRHT to usual care to assess its impact on testing rates, stigma, social support, and treatment outcomes. The intervention recruits newly diagnosed HIV-positive individuals seeds from clinics assigned to the E-SNRHT condition, who receive education about HIV transmission and are asked to recruit members of their expanded social networks for HIV testing. These network members are then tested and referred to treatment if positive or to follow-up testing if negative. The study uses recruitment coupons to maintain confidentiality and extends recruitment to secondary network members through a two-step process. Control clinics provide standard HIV testing and care without the expanded recruitment. Participants complete baseline interviews covering demographics, behaviors, stigma, and social support, with follow-up interviews at six months to track HIV-related behaviors and treatment outcomes. The study includes qualitative interviews with a subset to explore experiences of peer recruitment and stigma. Researchers will collect clinic data on ART initiation and viral suppression, monitor implementation fidelity, and evaluate intervention effects on male testing rates, new HIV diagnoses, stigma, social support, and HIV care cascade outcomes over the study period ending in 2027.

Expanded Social Network Recruitment to HIV Testing (E-SNRHT) Intervention to Locate Undiagnosed Cases and Reduce HIV-related Stigma