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Randomized Controlled Trial
. 2023 Jan;72(1):64-72.
doi: 10.1016/j.jadohealth.2022.08.013. Epub 2022 Oct 12.

Reaching Adolescent Girls and Young Women With HIV Self-Testing and Contraception at Girl-Friendly Drug Shops: A Randomized Trial in Tanzania

Lauren A Hunter  1 , Aarthi Rao  2 , Sue Napierala  3 , Atuganile Kalinjila  4 , Agatha Mnyippembe  4 , Kassim Hassan  4 , Stefano M Bertozzi  5 , Rashid Mfaume  6 , Prosper Njau  7 , Jenny X Liu  8 , Sandra I McCoy  5
Affiliations
Randomized Controlled Trial

Reaching Adolescent Girls and Young Women With HIV Self-Testing and Contraception at Girl-Friendly Drug Shops: A Randomized Trial in Tanzania

Lauren A Hunter et al. J Adolesc Health. 2023 Jan.

Abstract

Purpose: We hypothesized that an intervention designed to create girl-friendly drug shops would increase access to sexual and reproductive health products and services among adolescent girls and young women (AGYW) (ages 15-24 years) in Tanzania.

Methods: We conducted a four-month randomized trial at 20 drug shops in Shinyanga, Tanzania from August-December 2019 to determine if the Malkia Klabu ("Queen Club") intervention increased AGYW patronage and the provision of HIV self-testing (HIVST), contraception, and health facility referrals to AGYW (primary outcomes). Drug shops were randomized 1:1 to the intervention or comparison arm. All shops were provided with OraQuick HIVST kits to give to AGYW for free. Intervention shops implemented Malkia Klabu, a loyalty program for AGYW created using human-centered design through which AGYW could also access free contraception. We compared outcomes in intention-to-treat analyses using shop observations and shopkeeper records.

Results: By endline, shops implementing Malkia Klabu had higher AGYW patronage than comparison shops (rate ratio: 4.4; 95% confidence interval: 2.0, 9.8). Intervention shops distributed more HIVST kits (median per shop: 130.5 vs. 58.5, P = .02) and contraceptives (325.5 vs. 7.0, P < .01) to AGYW and provided more referrals for HIV, family planning, or pregnancy services combined (3.5 vs. 0.5, P = .02) than comparison shops.

Discussion: The Malkia Klabu intervention increased AGYW patronage and the provision of HIVST kits, contraception, and referrals to AGYW at drug shops, despite HIVST kits being freely available at all participating shops. Enhancing drug shops with girl-friendly services may be an effective strategy to reach AGYW with sexual and reproductive health services.

Trial registration: ClinicalTrials.gov NCT04045912.

Keywords: Adolescent girls and young women; Contraception; Drug shops; HIV self-testing; Human-centered design; Tanzania.

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Conflict of interest statement

Declaration of interests: We declare no competing interests.

Figures

Figure 1.
Figure 1.
Trial profile for the randomized trial evaluating the Malkia Klabu intervention.
Figure 2.
Figure 2.
Patronage of adolescent girls and young women (AGYW) compared to other customers (non-AGYW) at 20 drug shops, assessed via multiple three-hour shop observations per shop, by time point and study arm.
See this image and copyright information in PMC

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