Project Summary There is a critical need for heterosexual men in Sub-Saharan Africa (SSA) to receive HIV care, including antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP), following an HIV self-test (HIVST). Heterosexual men in SSA are routinely shown to be at a high risk for HIV acquisition, but test at lower rates than women and experience inadequate linkages to HIV care following a self-test, regardless of the test result. Tanzania’s Sauti Project was launched in 2015 by the Tanzania Ministry of Health (MoH) and included the piloting of HIVST and community-based PrEP and ART administration for women, female sex workers, and men who have sex with men. However, heterosexual men were not included in this study, despite their high risk. Based on feedback from men that peer-based navigation and community-based linkage to care services are preferrable to facility-based HIV care, the STEP+cbNIMART intervention was developed. There are three aims to this study. Aim 1.) Tailor the STEP+cbNIMART intervention for heterosexual male self- testers. In Aim 1, the intervention will be further tailored to men through a “theater test” and feedback from key stakeholders and topical experts, and later utilized for training Community Based Health Service Providers (CBHSPs) who will help deliver the intervention. Aim 2.) Test the effectiveness of the STEP+cbNIMART intervention on ART or PrEP initiation and retention for male self-testers. We will conduct a cRCT using a hybrid type I implementation-effectiveness study design to assess the effectiveness of the intervention. The cRCT will include an intervention and control arm, with intervention participants receiving nurse-led community-based ART and PrEP initiation, and control arm participants receiving the standard of care. ART and PrEP adherence will be measured through a baseline survey and subsequent follow-ups of participants in both arms. Aim 3.) Evaluate the facilitators and barriers of implementing the intervention to refine the intervention for adoption in other settings. We will use a qualitative approach to explore facilitators and barriers affecting nurses’ and CBHSPs’ abilities to implement the intervention and men’s abilities to participate in the intervention and refinements that are needed to make the intervention as successful as possible.