Mobile Health–Supported HIV Self-Testing Strategy Among Urban Refugee and Displaced Youth in Kampala, Uganda: Protocol for a Cluster Randomized Trial (Tushirikiane, Supporting Each Other
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
JMIR research protocols
Abstract
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.
Description
Keywords
Adolescents and youth, Implementation research, HIV testing, Mobile health, Refugee, Uganda
Citation
Logie, C., Okumu, M., Hakiza, R., Musoke, D. K., Berry, I., Mwima, S., ... & Mbuagbaw, L. (2021). Mobile health–Supported HIV self-testing strategy among urban refugee and displaced youth in Kampala, Uganda: Protocol for a cluster randomized trial (Tushirikiane, Supporting Each Other). JMIR research protocols, 10(2), e26192. doi: 10.2196/26192