Changes in Sexual Risk-taking Behaviours Among Men After Participating in the PEST4MEN HIV Self-Testing Intervention in Two Fishing Communities in Central Uganda.

BACKGROUND

The availability of free HIV self-test kits in the community may alter people's sexual behaviours in some way. However, little evidence exists to confirm or refute this assertion. We assessed changes in sexual risk-taking behaviours among men living in a fishing community before and after participating in an HIV self-testing (HIVST) intervention.

METHODS

This was a secondary analysis of data collected as part of a large peer-led HIVST intervention for men (PEST4MEN) in two fishing communities located in Kalangala (1) and Buvuma (1) Island districts. Following a baseline interview in July 2022, enrolled men (n=400) received oral fluid-based HIV self-test kits from their peer leaders and were followed up in September 2022 (n=361) to determine use. Data were collected on socio-demographic and behavioural characteristics using a structured questionnaire, configured in the KoboCollect tool, and loaded on mobile phones. We assessed changes in the proportion of men reporting multiple (2+) sexual partners, alcohol use before sex and condom use frequency before and after HIVST. We conducted descriptive analysis using STATA (version 14.0). Comparisons between proportions were made using Pearson's chi-square test.

RESULTS

Of 361 men, 239 had complete HIVST and sexual behaviour data at the baseline and follow-up visits. Of these, 34.3% (n=82) were aged between 25 and 34 years with a mean age of 30.8 years (Standard Deviation: ±9.0). Fifty-six percent (n=134) were engaged in fishing or fishing-related activities. The proportion of men reporting multiple sexual partners reduced significantly from 52.3% (n=125) to 42.3% (n=101), P=.0279. However, there was a non-significant increase in condom use at last sex (from 17.2%, n=41, to 18.4%, n=44; P=.7197) and alcohol use before sex (from 10.0%, n=24, to 11.7%, n=28; P=.5568). Consistent condom use reduced somewhat between the two study visits (from 10.0%, n=24, to 8.0%, n=19; P=.4241).

CONCLUSION

The proportion of men reporting multiple sexual partnerships reduced significantly between the two study visits. However, this reduction was not observed in the other sexual risk behaviours. These findings suggest a need for integrating sexual risk-reduction messages into HIVST interventions in order to reduce sexual risk-taking behaviors among potential users of HIV self-test kits.