TY - JOUR
T1 - Mobile health–Supported HIV self-testing strategy among urban refugee and displaced youth in Kampala, Uganda
T2 - Protocol for a cluster randomized trial (Tushirikiane, Supporting Each Other)
AU - Logie, Carmen
AU - Okumu, Moses
AU - Hakiza, Robert
AU - Musoke, Daniel Kibuuka
AU - Berry, Isha
AU - Mwima, Simon
AU - Kyambadde, Peter
AU - Kiera, Uwase Mimy
AU - Loutet, Miranda
AU - Neema, Stella
AU - Newby, Katie
AU - McNamee, Clara
AU - Baral, Stefan D.
AU - Lester, Richard
AU - Musinguzi, Joshua
AU - Mbuagbaw, Lawrence
N1 - Funding Information:
This study has been funded by the Canadian Institutes of Health Research (project grant 389142). Funding agencies played no role in the design or execution of the study. CL is also funded by the Canada Research Chairs program (Tier 2: Logie), Canada Foundation for Innovation (Logie’s SSHINE Lab), and the Ontario Ministry of Research and Innovation (ERA: Logie).
Publisher Copyright:
© Carmen Logie, Moses Okumu, Robert Hakiza, Daniel Kibuuka Musoke, Isha Berry, Simon Mwima, Peter Kyambadde, Uwase Mimy Kiera, Miranda Loutet, Stella Neema, Katie Newby, Clara McNamee, Stefan D Baral, Richard Lester, Joshua Musinguzi, Lawrence Mbuagbaw.
PY - 2021/2
Y1 - 2021/2
N2 - Background: HIV is the leading cause of mortality among youth in sub-Saharan Africa. Uganda hosts over 1.43 million refugees, and more than 83,000 live in Kampala, largely in informal settlements. There is limited information about HIV testing uptake and preferences among urban refugee and displaced youth. HIV self-testing is a promising method for increasing testing uptake. Further, mobile health (mHealth) interventions have been effective in increasing HIV testing uptake and could be particularly useful among youth. Objective: This study aims to evaluate the feasibility and effectiveness of two HIV self-testing implementation strategies (HIV self-testing intervention alone and HIV self-testing combined with an mHealth intervention) in comparison with the HIV testing standard of care in terms of HIV testing outcomes among refugee/displaced youth aged 16 to 24 years in Kampala, Uganda. Methods: A three-arm cluster randomized controlled trial will be implemented across five informal settlements grouped into three sites, based on proximity, and randomization will be performed with a 1:1:1 method. Approximately 450 adolescents (150 per cluster) will be enrolled and followed for 12 months. Data will be collected at the following three time points: baseline enrollment, 8 months after enrollment, and 12 months after enrollment. Primary outcomes (HIV testing frequency, HIV status knowledge, linkage to confirmatory testing, and linkage to HIV care) and secondary outcomes (depression, condom use efficacy, consistent condom use, sexual relationship power, HIV stigma, and adolescent sexual and reproductive health stigma) will be evaluated. Results: The study has been conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. The study has received ethical approval from the University of Toronto (June 14, 2019), Mildmay Uganda (November 11, 2019), and the Uganda National Council for Science and Technology (August 3, 2020). The Tushirikiane trial launched in February 2020, recruiting a total of 452 participants. Data collection was paused for 8 months due to COVID-19. Data collection for wave 2 resumed in November 2020, and as of December 10, 2020, a total of 295 participants have been followed-up. The third, and final, wave of data collection will be conducted between February and March 2021. Conclusions: This study will contribute to the knowledge of differentiated HIV testing implementation strategies for urban refugee and displaced youth living in informal settlements. We will share the findings in peer-reviewed manuscripts and conference presentations.
AB - Background: HIV is the leading cause of mortality among youth in sub-Saharan Africa. Uganda hosts over 1.43 million refugees, and more than 83,000 live in Kampala, largely in informal settlements. There is limited information about HIV testing uptake and preferences among urban refugee and displaced youth. HIV self-testing is a promising method for increasing testing uptake. Further, mobile health (mHealth) interventions have been effective in increasing HIV testing uptake and could be particularly useful among youth. Objective: This study aims to evaluate the feasibility and effectiveness of two HIV self-testing implementation strategies (HIV self-testing intervention alone and HIV self-testing combined with an mHealth intervention) in comparison with the HIV testing standard of care in terms of HIV testing outcomes among refugee/displaced youth aged 16 to 24 years in Kampala, Uganda. Methods: A three-arm cluster randomized controlled trial will be implemented across five informal settlements grouped into three sites, based on proximity, and randomization will be performed with a 1:1:1 method. Approximately 450 adolescents (150 per cluster) will be enrolled and followed for 12 months. Data will be collected at the following three time points: baseline enrollment, 8 months after enrollment, and 12 months after enrollment. Primary outcomes (HIV testing frequency, HIV status knowledge, linkage to confirmatory testing, and linkage to HIV care) and secondary outcomes (depression, condom use efficacy, consistent condom use, sexual relationship power, HIV stigma, and adolescent sexual and reproductive health stigma) will be evaluated. Results: The study has been conducted in accordance with CONSORT (Consolidated Standards of Reporting Trials) guidelines. The study has received ethical approval from the University of Toronto (June 14, 2019), Mildmay Uganda (November 11, 2019), and the Uganda National Council for Science and Technology (August 3, 2020). The Tushirikiane trial launched in February 2020, recruiting a total of 452 participants. Data collection was paused for 8 months due to COVID-19. Data collection for wave 2 resumed in November 2020, and as of December 10, 2020, a total of 295 participants have been followed-up. The third, and final, wave of data collection will be conducted between February and March 2021. Conclusions: This study will contribute to the knowledge of differentiated HIV testing implementation strategies for urban refugee and displaced youth living in informal settlements. We will share the findings in peer-reviewed manuscripts and conference presentations.
KW - Adolescents and youth
KW - HIV testing
KW - Implementation research
KW - Mobile health
KW - Refugee
KW - Uganda
UR - http://www.scopus.com/inward/record.url?scp=85100514235&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100514235&partnerID=8YFLogxK
U2 - 10.2196/26192
DO - 10.2196/26192
M3 - Article
C2 - 33528378
AN - SCOPUS:85100514235
SN - 1929-0748
VL - 10
JO - JMIR Research Protocols
JF - JMIR Research Protocols
IS - 2
M1 - e26192
ER -