# Secondary distribution of HIV self-tests: an innovative strategy for promoting male partner testing and reducing risk

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $513,660

## Abstract

Project Title
Secondary distribution of HIV self-tests by female sex workers: an innovative strategy for promoting male
partner testing and reducing HIV risk.
Project Summary/Abstract
Greater uptake of HIV testing among those likely to be HIV-infected is vital for meeting the first of the UNAIDS
“90-90-90” targets. However, roughly 55% of HIV-infected individuals in sub-Saharan Africa remain unaware of
their serostatus, with men having lower awareness than women. While community-based HIV testing
strategies have had considerable success in promoting HIV testing in the general population, there is a need
for innovative HIV testing strategies that can reach key populations and high-risk individuals such as male
partners of female sex workers. Interventions are also needed to promote couples testing, which can result in
improved sexual decision-making, including increased condom use and increased antiretroviral therapy use to
prevent sexual transmission. HIV self-testing is a promising approach that has the potential to substantially
increase access to testing in a manner that is confidential and empowering for users. Data from across the
globe demonstrate high interest in and acceptability of self-testing among a wide range of populations.
Although HIV self-testing can be a good alternative for those not engaged in regular repeat testing, little is
known about the optimal distribution strategies for facilitating self-test use by the hardest-to-reach individuals.
One innovative strategy is `secondary distribution' of HIV self-tests, whereby an individual who is given multiple
self-tests can distribute them to sexual partners or to others in their social network. This project will evaluate
whether secondary distribution of self-tests by female sex workers in Kenya can be used to fulfill multiple HIV
prevention goals, including the promotion of HIV testing among high-risk men and the facilitation of mutual
disclosure of serostatus, couples testing, and safer sexual decision making. By facilitating safer sexual
decision-making, secondary distribution of self-tests has the potential to reduce HIV incidence among female
sex workers, a population that faces an especially high risk of HIV infection. Building on preliminary data in
demonstrating that female sex workers can safely distribute oral self-tests to their sexual partners and make
safer sexual behavior decisions following self-testing, we will conduct a randomized controlled trial in which
female sex workers are randomized to receive multiple self-tests or a voucher to refer partners to clinic-based
HIV testing. In Aim 1, we will test whether secondary distribution of self-tests by female sex workers results in
greater identification of HIV-infected men and safer sexual behaviors. In Aim 2, we will conduct in-depth
interviews to assess study participants' experiences distributing self-tests to their sexual partners. In Aim 3, we
will determine the cost-effectiveness of secondary distribution of sel...

## Key facts

- **NIH application ID:** 9987760
- **Project number:** 5R01MH111602-06
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Harsha Thirumurthy
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $513,660
- **Award type:** 5
- **Project period:** 2016-09-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9987760

## Citation

> US National Institutes of Health, RePORTER application 9987760, Secondary distribution of HIV self-tests: an innovative strategy for promoting male partner testing and reducing risk (5R01MH111602-06). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9987760. Licensed CC0.

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