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Increasing the Uptake of HIV Testing among Men in Tanzania: A Novel Intervention for Bar Patrons

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Abstract

We investigated a novel community-based HIV testing and counseling (HTC) strategy by recruiting men from bars in northern Tanzania in order to identify new HIV infections. All bars in the town of Boma Ng’ombe were identified and male patrons were systematically invited to participate in a health study. HIV testing was offered to all enrolled participants. Outputs included HIV test yield, cost per diagnosis, and comparison of our observed test yield to that among male patients contemporaneously tested at five local facility-based HTC. We enrolled 366 participants and identified 17 new infections – providing a test yield of 5.3% (95% Confidence interval [CI] 3.3–8.4). The test yield among men contemporaneously tested at five local HTC centers was 2.1% (95% CI 1.6–2.8). The cost-per-diagnosis was $634. Our results suggest that recruiting male bar patrons for HIV testing is efficient for identifying new HIV infections. The scalability of this intervention warrants further evaluation.

Resumen

Investigamos una novedosa estrategia comunitaria de asesoramiento y pruebas de VIH (HTC) reclutando hombres de los bares del norte de Tanzania para identificar nuevas infecciones de VIH. Se identificaron todos los bares de la ciudad de Boma Ng'ombe y se invitó sistemáticamente a los clientes varones a participar en un estudio de salud. Se ofrecieron pruebas de VIH a todos los participantes inscritos. Los resultados incluyeron los resultados de las pruebas de VIH, el costo por diagnóstico y la comparación de nuestros resultados observados con los de los pacientes varones que simultáneamente se sometieron a pruebas en cinco centros locales de HTC. Se inscribieron 366 participantes y se identificaron 17 nuevas infecciones, proporcionando un resultado en las pruebas del 5.3% (intervalo de confianza [IC] del 95%: 3.3-8.4). Los resultados de las pruebas realizadas simultáneamente en cinco centros locales de HTC fue del 2.1% (IC del 95%: 1.6-2.8). El costo por diagnóstico fue de $634. Nuestros resultados sugieren que el reclutamiento de clientes masculinos para las pruebas de VIH fue eficiente para identificar nuevas infecciones de VIH. La escalabilidad de esta intervención merece una evaluación adicional.

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Acknowledgements

The authors would like to thank the study participants as well as the clinical staff and administration at the facility-based testing centers in Boma Ng’ombe. In addition, we would like to thank the village leaders and ward leaders in Hai district who supported the study.

Funding

This research was supported by the US NIH Fogarty International Center grant D43TW009337. DBM and PM received support from the NIH Ruth L. Kirschstein National Research Service Award (NRSA) 5T32AI007392.

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Authors and Affiliations

  1. Department of Medicine, Duke University, 315 Trent Drive, Durham, NC, 27710, USA

    Deng B. Madut, Preeti Manavalan & Nathan M. Thielman

  2. Duke Global Health Institute, Durham, NC, USA

    Deng B. Madut, Preeti Manavalan & Nathan M. Thielman

  3. Kilimanjaro Christian Medical Centre, Moshi, Tanzania

    Antipas Mtalo & Timothy A. Peter

  4. Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Jan Ostermann

  5. Kilimanjaro Christian Medical University College, Moshi, Tanzania

    Bernard Njau

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  1. Deng B. Madut
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Contributions

DBM and NMT conceived the study; DBM and NMT designed the study protocol; DBM, BN, and NMT implemented and supervised the study; DBM performed the data analysis; DBM drafted the manuscript; DBM, PM, AM, TP, JO, BN, and NMT critically revised the manuscript for content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Deng B. Madut.

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Conflict of interest

The authors report no conflicts of interest related to this work.

Ethical Approval

Ethics approval was obtained from the Institutional Review Board of Duke University, the Research Ethics Committee of Kilimanjaro Christian Medical Centre, and the Ethics Coordinating Committee of the Tanzanian National Institute for Medical Research.

Informed Consent

Written consent was obtained from all participants.

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Madut, D.B., Manavalan, P., Mtalo, A. et al. Increasing the Uptake of HIV Testing among Men in Tanzania: A Novel Intervention for Bar Patrons. AIDS Behav 25, 2014–2022 (2021). https://doi.org/10.1007/s10461-020-03131-6

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