Abstract
BACKGROUND: Partners of people living with HIV (PLHIV) at high risk of HIV acquisition are a target population who may benefit from innovative HIV testing strategies. We explored the effectiveness of the secondary distribution of HIVST kits by PLHIV enrolled in HIV care to catalyze testing and linkage to care. METHODS: A prospective interventional study was conducted at four Kenyan HIV clinics deploying two testing strategies sequentially to reach sexual partners of PLHIV: 1) invitation by PLHIV for clinic-based testing and 2) distribution of HIVST kits by PLHIV. PLHIV were newly diagnosed with HIV or had been using antiretroviral therapy (ART) for <6 months or were not virally suppressed, with a sexual partner of unknown HIV status or whose sexual partner had tested >3 months ago. In-person interviewer-administered surveys were conducted with partners to determine whether they completed HIV testing and were linked to any follow-up care. RESULTS: A total of 345 PLHIV (167 invitation and 178 HIVST) and 274 (79.4%) of their sexual partners (135 invitation and 139 HIVST) were enrolled. Partners were more likely to get tested (98.6% vs. 77.8%, PPR=1.27, 95% CI [1.16- 1.39]) and to link to care (71.9% vs. 50.3%, PPR=1.43, 95% CI [1.17 - 1.74]) during the HIVST phase compared to the clinic phase. Among the subset of partners who tested HIV-positive, all were linked to care. CONCLUSION: HIVST delivery by PLHIV increased the frequency of HIV testing and linkage to care among their partners. This strategy warrants further investigation to determine its potential for scale-up.