# Self-Test Strategies and Linkage Incentives to Improve ART and PrEP Uptake in Men

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $604,125

## Abstract

Project Summary
Ending the AIDS epidemic in sub-Saharan will require further engagement of men in HIV testing, prevention,
and treatment, a challenging task given that nearly 50% of HIV-positive men in many countries are unaware of
their HIV status and men have lower uptake of HIV antiretroviral therapy (ART) and pre-exposure prophylaxis
(PrEP). This study focuses on a highly mobile population of men – fishermen – in Kenya’s Lake Victoria
shoreline communities, where HIV incidence rates are extremely high. Two recent innovations – HIV self-
testing (HIVST) and social network-based interventions – hold promise for overcoming barriers to HIV testing
and linkage to services for both HIV-positive and HIV-negative men. This study seeks to determine if an HIV
status-neutral, social network-based approach, along with low-cost incentives, can promote HIV testing,
linkage to care and prevention, and better health outcomes in men. It will pursue three aims:
Aim 1: Determine whether providing HIV self-tests to network-central men for distribution to other men
in their close social networks increases men’s HIV testing uptake. We will conduct social network
 mapping in study communities in Siaya Country, Kenya to identify distinct close social networks of men.
 We will then randomize these social networks to intervention and control groups. Network-central, highly-
 connected men in each network will be recruited as “promoters”, and receive HIVST training. Promoters in
 networks assigned to the intervention will then receive self-tests for distribution to men in their networks.
 Promoters in networks assigned to the control will instead distribute vouchers for free self-tests at nearby
 health clinics. We hypothesize higher HIV testing among men in networks that receive the intervention.
Aim 2: Determine whether network-central promoters and small incentives can increase ART and PrEP
uptake among men. We will test whether network-central promoters can enhance linkage to ART and PrEP
 after self-testing, thereby addressing a key limitation of HIVST. Promoters in the Aim 1 intervention group
 will be asked to distribute information and transport vouchers for ART or PrEP to men in their networks. Our
 primary hypothesis is that the intervention will result in higher rates of linkage to ART or PrEP (confirmatory
 testing and ART referral for positives, and PrEP screening for negatives). We also hypothesize higher ART
 and PrEP uptake within 3 months among men in social networks assigned to the intervention group.
Aim 3: Test the impact of interventions on ART or PrEP retention and adherence. We will measure 6-
and 12-month VL and tenofovir levels, using a recently-developed low-cost, point-of-care PrEP adherence
urine immunoassay. Across all aims, we will use qualitative and mixed methods to identify the pathways
of intervention action, and understand how social networks and incentives affect testing and ART and PrEP
uptake and retention. This study promises high...

## Key facts

- **NIH application ID:** 10433985
- **Project number:** 5R01MH120176-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Carol Suzanne Camlin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $604,125
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10433985

## Citation

> US National Institutes of Health, RePORTER application 10433985, Self-Test Strategies and Linkage Incentives to Improve ART and PrEP Uptake in Men (5R01MH120176-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10433985. Licensed CC0.

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