Text message reminders and peer education increase HIV and Syphilis testing among female sex workers: a pilot quasi-experimental study in Uganda

BMC Health Services Research

Richard Muhindo¹  Barbara Castelnuovo²  Rosalind Parkes-Ratanshi³  Andrew Mujugira⁴  Nelson K. Sewankambo⁵  Edith Nakku-Joloba⁶  Nazarius Mbona Tumwesigye⁶  Juliet Kiguli⁶ 

[1] Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda;Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda;Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda;Cambridge Institute of Public Health, University of Cambridge, Cambridge, United Kingdom;Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda;School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda;School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda;School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda;

关键词: HIV;    Syphilis;    Testing;    Female Sex Workers;    Africa;    Text Messages;   

DOI  :  10.1186/s12913-021-06461-w

来源: Springer

【 摘 要 】

BackgroundGlobally, female sex workers (FSW) are disproportionately affected by HIV and other sexually transmitted infections (STIs). However, uptake of STI and HIV testing services among FSW in sub-Saharan Africa remains low. We aimed to assess the effect of FSW-led peer education and text message reminders on 3-monthly syphilis and HIV testing among FSW in Uganda.MethodsBetween September 2019 and February 2020, we implemented weekly peer education sessions and bi-monthly SMS reminders for FSW in Mbarara (intervention city). Peer education sessions were implemented by 20 FSW, who received five days of basic training as peer educators. We held monthly meetings with peer educators throughout the six-month implementation period. FSW in Mbale (control city) continued to receive standard of care consisting of HIV testing outreach campaigns, and facility-based testing. Using a quasi-experimental design in one intervention city, and one control city, we conducted pre- and post- questionnaire-based surveys on recent syphilis and HIV testing behavior among FSW in July-October 2018, and March 2020. We compared proportions and prevalence ratios at baseline and follow-up using chi-square tests and negative binomial regression.ResultsWe conducted 436 interviews (200 before/236 after) with FSW. At baseline similar proportions reported taking an HIV test (57 % vs. 54 %; p = 0.72), and a syphilis serology test (35 % vs. 39 %; p = 0.67) in the intervention and control cities, respectively, in the prior three months. After the intervention, this proportion increased to 82 % (95 % confidence interval [CI] 74.0-88.2) for HIV, and 81 % (95 % CI: 73.0–87.0) for syphilis in the intervention city. Relative to baseline in the control city, the proportion testing for HIV was unchanged (52 %) but decreased for syphilis (26 %).ConclusionsBi-monthly text message reminders with weekly peer education sessions increased uptake of 3-monthly syphilis and HIV testing in a Ugandan female sex work population and could help increase sex worker engagement in HIV/STI services in line with World Health Organization recommendations.

【 授权许可】

CC BY