HIV Self-testing and Coupons Distribution by Persons Using PrEP to Create Demand for Combination HIV Prevention Services Among Men Who Have Sex With Men and Transgender Women: A Randomized Clinical Trial in the Context of the ImPrEP Project

Hoagland B.; Torres T.S.; Konda K.; Moreira R.I.; Leite I.C.; Cunha M.; Campos K.; Calvo G.; Pimenta C.; Benedetti M.; Rocha C.; Grangeiro J.R.; Bastos E.; Nazer S.; Palombo C.; de Vasconcellos M.; Caceres C.F.; Grinzstejn B.; Veloso V.G. · Journal of Acquired Immune Deficiency Syndromes (1999) (2026) · DOI: 10.1097/qai.0000000000003887

Resumen

Background: – Despite progress in HIV treatment in Latin America, prevention efforts lag. This study assessed whether the secondary distribution of HIV self-testing (HIVST) and coupons by men who have sex with men and transgender women using preexposure prophylaxis (PrEP) is feasible and could create demand for combination HIV prevention services. Settings: – Substudy of the PrEP Implementation Project conducted at 2 sites in Rio de Janeiro, Brazil, and 3 sites in Lima, Peru. Methods: – A randomized controlled trial among participants using oral PrEP for at least 6 months. Participants were randomized 1:1 to receive either 5 HIVST kits with coupons or 5 coupons alone and were instructed to distribute these within their networks. Outcomes included intervention efficacy (percentage of participants recruited) and recruitment efficacy (percentage of participants who recruited at least one person). Trial: – NCT03642314 (clinicaltrials.gov). Results: – A total of 694 participants using PrEP were enrolled: 351 (50.6%) HIVST + coupons arm and 343 (49.4%) coupons only arm. Three thousand four hundred seventy coupons were distributed, and 2472 (71.2%) were delivered for recruitment purposes. Overall, 321 individuals were recruited (Brazil: 155; Peru: 166). The coupon-only arm was more effective in recruiting individuals in Peru (21.9% vs. 12.0%, risk ratio: 0.55 [95% confidence interval: 0.41–073]) and Brazil (28.4% vs. 22.4%, risk ratio: 0.75 [95% confidence interval: 0.52–1.02]). Recruitment efficacy did not differ across arms in either country. Most individuals recruited (84.5%) believed that receiving coupons or HIVST motivated them to attend the service. Conclusion: – Both HIVST and coupons were successful in recruiting men who have sex with men and transgender women for combination HIV prevention services. Peer engagement of participants using PrEP can contribute to demand creation and strengthen linkage across the HIV prevention cascade. Copyright

Instituciones: Universidad Peruana Cayetano Heredia