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Pilot Testing Two Versions of a Social Network Intervention to Increase HIV Testing and Case-finding among Men in South Africa’s Generalized HIV Epidemic

Leslie D. Williams (), Alastair van Heerden, Xolani Ntinga, Georgios K. Nikolopoulos, Dimitrios Paraskevis and Samuel R. Friedman
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Leslie D. Williams: Division of Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL 60612, USA
Alastair van Heerden: Sweetwaters Centre for Community Based Research, Human Sciences Research Council, Pietermaritzburg 3201, South Africa
Xolani Ntinga: Sweetwaters Centre for Community Based Research, Human Sciences Research Council, Pietermaritzburg 3201, South Africa
Georgios K. Nikolopoulos: Medical School, University of Cyprus, Nicosia 1678, Cyprus
Dimitrios Paraskevis: Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
Samuel R. Friedman: Department of Population Health, New York University School of Medicine, New York, NY 10016, USA

IJERPH, 2023, vol. 21, issue 1, 1-10

Abstract: Locating undiagnosed HIV infections is important for limiting transmission. However, there is limited evidence about how best to do so. In South Africa, men have been particularly challenging to reach for HIV testing due, in part, to stigma. We pilot-tested two versions of a network-based case-finding and care-linkage intervention. The first, TRIP, asked “seeds” (original participants) to recruit their sexual and/or injection partners. The second, TRIPLE, aimed to circumvent some stigma-related issues by asking seeds to recruit anyone they know who might be at risk of being HIV-positive-unaware. We recruited 11 (18% male) newly diagnosed HIV-positive (NDP) seeds from two clinics in KwaZulu-Natal, South Africa and randomly assigned them to either TRIP or TRIPLE. Network members were recruited two steps from each seed. The TRIP arm recruited 12 network members; the TRIPLE arm recruited 62. Both arms recruited NDPs at higher rates than local clinic testing, with TRIP (50.0%) outperforming ( p = 0.012) TRIPLE (14.5%). However, TRIPLE (53.2%) was far superior to clinics (27.8%) and to TRIP (25.0%) at recruiting men. Given challenges around testing and treating men for HIV in this context, these findings suggest that the TRIPLE expanded network-tracing approach should be tested formally among larger samples in multiple settings.

Keywords: HIV case-finding intervention; social networks; HIV testing; South Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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