Evaluation of the iCARE Nigeria Pilot Intervention Using Social Media and Peer Navigation to Promote HIV Testing and Linkage to Care Among High-Risk Young Men: A Nonrandomized Controlled Trial.

Journal: JAMA network open

Volume: 5

Issue: 2

Year of Publication: 2022

Affiliated Institutions:  Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Department of Family Medicine, University College Hospital, Ibadan, Nigeria. Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Nigeria. Department of Obstetrics and Gynecology, College of Medicine, University of Ibadan, Ibadan, Nigeria. Division of Infectious Diseases and Center for Global Health, Northwestern University, Chicago, Illinois. Department of Medical Social Sciences, Northwestern University, Chicago, Illinois. Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria. Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. Infectious Disease Institute, College of Medicine, University of Ibadan, Ibadan, Nigeria. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.

Abstract summary 

Nigeria has the fourth-largest HIV epidemic globally, yet high levels of social stigma inhibit HIV testing among Nigerian youths and young men who have sex with men (MSM).To report pilot data from iCARE Nigeria (Intensive Combination Approach to Roll Back the Epidemic in Nigerian Adolescents), a combination intervention using social media and peer navigation to promote HIV testing and linkage to care among high-risk youths and young men (hereinafter referred to as young men), including predominantly young MSM.This nonrandomized controlled study assessed an organizational and community-level 12-month, preintervention-postintervention pilot trial of a combination intervention designed to increase HIV testing uptake, increase the rate of identified seropositive cases, and improve linkage to care among young men, including MSM, using social media outreach and peer navigation. Data were collected from June 1, 2019, to May 30, 2020. Participants were young men aged 15 to 24 years in the city of Ibadan, Nigeria, and surrounding areas. Frequencies and percentages were examined, and a Fisher exact test was used to evaluate outcomes compared with historical surveillance data. Linkage to care was defined as 2 clinic visits, including HIV confirmation, within 2 months of a positive rapid test result.Four peer navigators conducted social media outreach promoting sexual health and guiding individuals to HIV counseling and rapid testing in clinical, community, or home-based settings.Primary outcomes included the number of young men tested for HIV at university-based iCARE catchment clinics or by iCARE peer navigators in the community, the postintervention HIV seroprevalence of these groups, and linkage to care of participants diagnosed with HIV infection.A total of 339 participants underwent testing for HIV (mean [SD] age, 21.7 [1.9] years), with 283 (83.5%) referred through social media. The main referral sources for social media were WhatsApp (124 [43.8%]), Facebook (101 [35.7%]), and Grindr (57 [20.1%]). Regarding testing location, participants chose home (134 [39.5%]), community-based (202 [59.6%]), or clinic (3 [0.9%]) settings. Eighty-six participants reported no prior HIV testing. Thirty-six participants (10.6%) were confirmed as HIV seropositive; among those, 18 (50.0%) reported negative test results within the past year, and 31 (86.1%) were linked to care. In two 6-month follow-up periods, the intervention increased HIV testing by 42% and 31%, respectively, and seroprevalence increased compared with historical trends with odds ratios of 3.37 (95% CI, 1.43-8.02; P = .002) and 2.74 (95% CI, 1.10-7.11; P = .02), respectively.These findings suggest that use of iCARE Nigeria was associated with increased HIV testing and linkage to care in a high-risk, difficult-to-reach population, making it a promising combination intervention for young MSM.isrctn.org Identifier: ISRCTN94590823.

Authors & Co-authors:  Garofalo Robert R Adetunji Adedotun A Kuhns Lisa M LM Omigbodun Olayinka O Johnson Amy K AK Kuti Kehinde K Awolude Olutosin A OA Berzins Baiba B Janulis Patrick P Okonkwor Ogochukwu O Oladeji Bibilola B Muldoon Abigail L AL Amoo Oluwaseun P OP Atunde Hannah H Kapogiannis Bill B Taiwo Babafemi O BO

Study Outcome 

Source Link: Visit source

Statistics
Citations :  AVERT . HIV and AIDS in Nigeria. Updated August 2, 2020. Accessed September 5, 2020. https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/nigeria
Authors :  16
Identifiers
Doi : e220148
SSN : 2574-3805
Study Population
Men
Mesh Terms
Adolescent
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
United States