Abstract
Background
Targeted peer mobilisation can improve access to HIV testing and care and may impact onward HIV transmission. We describe a qualitative exploration of the experience with a peer mobilisation training programme for oral HIV self-testing (OST) and referral for acute HIV infection (AHI) testing among gay and bisexual men (GBMSM) and transgender women (TGW) in coastal Kenya.
Methods
The training programme covered five modules: 1) safe sex, 2) OST, 3) AHI, 4) HIV partner notification services, and 5) mobilisation skills. Mobilisers attended two training sessions and weekly meetings between March and June 2019. Mobilisers offered OST to GBMSM and TGW peers and extended an AHI referral card for point-of-care HIV-RNA testing when peers reported AHI symptoms. Two focus group discussions with 18 mobilisers and 15 in-depth interviews with mobilised clients who were newly HIV diagnosed were conducted to explore the experiences of the training programme.
Results
Mobilisers felt empowered through the training programme, which enhanced their mobilisation skills across two areas: (1) networking skills and (2) client empowerment. Facilitators for HIV testing were confidentiality of the OST, presence of STI symptoms, and building trust between mobilisers and clients. Mobilisers and clients reported challenges as: (1) misconceptions regarding OST and symptoms of AHI, (2) logistical and financial issues, and (3) stigma and security concerns.
Discussion
Our training programme facilitated peer mobilisers to extend OSTs among GBMSM and TGW in coastal Kenya while it was more difficult to refer clients directly for AHI testing. Mobilisers felt empowered through enhanced mobilisation skills which helped them to mobilise clients for HIV testing. A targeted training programme was helpful in mobilising peers to take up HIV testing.
| Original language | English |
|---|---|
| Article number | e0322255 |
| Pages (from-to) | 1-15 |
| Number of pages | 15 |
| Journal | PLoS ONE |
| Volume | 20 |
| Issue number | 12 |
| Early online date | 4 Dec 2025 |
| DOIs | |
| Publication status | Published - Dec 2025 |
Bibliographical note
Publisher Copyright:© 2025 Palmer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding
This work was supported by the International AIDS Vaccine Initiative (IAVI) [www.iavi.org] and the KEMRI Wellcome Trust Research Programme [www.kemriwellcome. org] at the Centre for Geographical Medicine Research–Kilifi, supported by core funding from the Wellcome Trust [www.wellcome.org] (number 203077). This study was made possible by the generous support of the American people through USAID [www.usaid.gov]. This work was also supported in part through the Sub-Saharan African Network for TB/HIV Research Excellence [www.santheafrica.org], a DELTAS Africa Initiative (DEL-15-006). The DELTAS Africa Initiative is an independent funding scheme of the AAS Alliance for Accelerating Excellence in Science in Africa and is supported by NEPAD [www.nepad.org] with funding from the Wellcome Trust (grant number 107752) and the UK government [www.gov.uk/government/ organisations/foreign-commonwealth-development-office]. E. J. S. received research funding from IAVI, NIH (grant number R01AI124968) and the Wellcome Trust. M. D. received funding through a PhD Scholarship from the Graduate School of Amsterdam UMC–Academic Medical Center [www.amsterdamumc.org/en/phd-student.htm]. The sponsors played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. We would like to acknowledge all participants who took part in this study. We further acknowledge the peer mobilizers in Malindi and Mtwapa who were invaluable for mobilizing participants and their support in both this study and the parent study, and the following lesbian, gay, bisexual, transgender and intersex organizations involved in the study: Malindi Desire Initiative, AMKENI Malindi, HAPA Kenya, PEMA Kenya, GALCK, and ISHTAR MSM Health and Social Wellbeing. We would also like to acknowledge the Kenya Medical Research Institute (KEMRI)–Wellcome Trust Research Programme clinic staff who made this study possible: Abdallah Wesonga, Oscar Chirro, Joseph Nzioka, Maxwell Ong’aro, Fred Ogada, Elizabeth Wahome, Rufus Gathitu, Lucie Ikumi, Jennifer Kanungi, Riziki Rodgers, and John Omoi.
| Funders | Funder number |
|---|---|
| ISHTAR MSM Health and Social Wellbeing | |
| Malindi Desire Initiative | |
| International AIDS Vaccine Initiative | |
| Wellcome | |
| Government of the United Kingdom | |
| Kenya Medical Research Institute | |
| Wellcome Trust | 203077 |
| United States Agency for International Development | DEL-15-006 |
| New Partnership for Africa's Development | 107752 |
| National Institutes of Health | R01AI124968 |