Target Area

Researchers are investigating new ways to improve HIV testing, treatment, and prevention among men in Eastern Zimbabwe, where HIV remains a significant health concern. Men in this region are less likely to engage with existing HIV prevention services, which contributes to ongoing HIV transmission, especially to women. This study aims to evaluate how distributing HIV self-testing kits through male peer networks, combined with phone support and improved awareness of HIV risk, impacts the uptake of HIV prevention medication called PrEP (Pre-Exposure Prophylaxis). The study uses a cluster-randomized design involving 44 community clusters. In intervention clusters, selected male distributors receive HIV self-testing kits for themselves and additional kits to share with peers. These peers may also become distributors, creating a network of kit distribution. A toll-free helpline offers pre- and post-test support, and SMS-based risk assessments help speed up PrEP initiation at clinics. In control clusters, HIV self-testing kits are distributed by community health workers. The intervention is supported by follow-up calls, incentives for kit distribution, and tracking of referrals to clinics for confirmatory testing. Participants will be followed for six months to monitor PrEP initiation and adherence. Researchers will collect demographic and behavioral data, track the distribution and use of HIV self-testing kits, and assess confirmatory testing outcomes through clinic visits. Monthly contact will support those starting PrEP or treatment, and blood samples will be collected at the end of follow-up to verify medication adherence. This comprehensive approach aims to measure the effectiveness and cost-effectiveness of male peer-led HIV self-testing and prevention efforts in this high-risk population.