Using UU Messaging to Improve HIV Testing, Treatment Start, and Care for Men in South Africa

What this Trial Is About

Researchers are evaluating the impact of Undetectable Equals Untransmittable UU messaging and counseling on improving HIV care among men in two South African provinces. The study aims to increase HIV testing uptake and antiretroviral treatment ART initiation, as well as to improve viral suppression and retention in care. This research builds on evidence that men living with HIV face testing and treatment gaps compared to women, and that addressing these gaps may reduce new HIV infections among women and help achieve global HIV targets by 2030. The study involves two main interventions using human-centered, behavioral nudge-informed UU messaging. In Aim 1, trained health promoters use UU messaging scripts during community-based HIV testing to encourage men to get tested and link those testing positive to ART services. In Aim 2, men starting or restarting ART receive UU adherence messages alongside standard counseling, including monthly SMS and in-clinic booster messages to support treatment adherence and viral suppression. Comparison groups receive standard care messaging for testing and treatment. Participants will be followed to assess outcomes including ART initiation within 30 days of testing invitation and viral load suppression at 6 months. Additional measures include testing agreement rates at baseline and retention in care at 12 months. The study includes informed consent, monthly follow-ups, and multi-method evaluations to inform future UU messaging programs. Total participation time varies by individual progress through the testing and care cascade.

Improving HIV Testing, Linkage, and Retention in Care for Men Through U=U Messaging