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Randomized Controlled Trial
. 2021 Feb 11;11(1):87-95.
doi: 10.1093/tbm/ibz157.

Overcoming cultural barriers to implementing oral HIV self-testing with high fidelity among Tanzanian youth

Joseph A Catania  1 , Cassidy Huun  2 , M Margaret Dolcini  1 , Angelmary Joel Urban  1 , Nick Fleury  1 , Clinton Ndyetabula  3 , Ryan Singh  1 , Amy W Young  1 , Donaldson F Conserve  4 , James Lace  3 , Joyce Samweli Msigwa  3
Affiliations
Randomized Controlled Trial

Overcoming cultural barriers to implementing oral HIV self-testing with high fidelity among Tanzanian youth

Joseph A Catania et al. Transl Behav Med. .

Abstract

Tanzanian youth have high levels of HIV risk and poor access to HIV-testing. Oral self-implemented testing (Oral-SIT) provides an alternative that reduces barriers to HIV-testing. We examined adaptations to Oral-SIT training components in a randomized experiment to evaluate a "train-the-trainer" strategy for improving comprehension of graphic training materials. Participants (N = 257, age = 14-19 years) were randomly assigned to one of two self-training conditions: graphic instruction book (GIB) or Video-GIB. Outcomes included behavioral performance fidelity, self-reported comprehension, and intentions to seek treatment. Video-GIB participants, relative to GIB-only participants, had higher performance fidelity scores, made fewer performance errors, had better instruction comprehension, and were more likely to intend to seek treatment. Oral-SIT timing errors were significantly more common among GIB-only participants. Graphic training materials in conjunction with a "train-the-trainer" video has significant potential for increasing Oral-SIT's reach by overcoming technological and literacy barriers.

Keywords: Fidelity; Oral-HIV self-testing; Self-implementation; Tanzania.

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