JMIR Publications

ABSTRACT

HIV is the leading cause of mortality among youth in sub-Saharan Africa. Uganda hosts over 1.43 million refugees, and more than 83,000 live in Kampala, largely in informal settlements. There is limited information about HIV testing uptake and preferences among urban refugee and displaced youth. HIV self-testing (HIVST) is a promising method for increasing testing uptake. Further, mobile-health (mHealth) interventions have been effective in increasing HIV testing uptake and could be particularly useful amongst youth. This study aims to evaluate the feasibility and effectiveness of two HIVST implementation strategies (HIVST intervention alone, HIVST combined with mHealth intervention) in comparison with the HIV testing standard of care, on HIV testing outcomes amongst refugee/displaced youth aged 16-24 years in Kampala, Uganda. A three-arm cluster randomized controlled trial will be implemented across five informal settlements grouped into three sites, based on proximity, and randomized in a 1:1:1 method. Approximately 450 adolescents (150 per cluster) will be enrolled and followed for twelve months. Data will be collected at three-time points: baseline enrollment, eight-months after enrollment, and twelve-months after enrollment. Primary outcomes (HIV testing frequency, HIV status knowledge, linkage to confirmatory testing, and linkage to HIV care) and secondary outcomes (depression, condom use efficacy, consistent condom use, sexual relationship power, HIV stigma, and adolescent sexual and reproductive health stigma) will be evaluated. The study has been conducted according to the CONSORT statement. All participants signed a consent form, and the study has been approved by the University of Toronto, Mildmay Uganda, and the Uganda National Council for Science and Technology. This study will contribute to the knowledge of differentiated HIV testing implementation strategies for urban refugee and displaced youth living in informal settlements and we will share findings in peer-reviewed manuscripts and conference presentations. Trial Registration: ClinicalTrials.gov NCT04504097.