Published in PLOS One on 2025-12-04, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Shaun Palmer, Maartje Dijkstra, Alex Kigoro, Khamisi Mohamed, Nana Mukuria, Shally Mahmoud, Evanson Gichuru, Elise M van der Elst, Eduard J Sanders, Juan Pablo Gutierrez
Source: PLOS One • DOI 10.1371/journal.pone.0322255
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
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.
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.
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.
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.
Introduction
Gay and bisexual men and transgender women who have sex with men (GBMSM and TGW) represent key and vulnerable populations for HIV acquisition in Kenya. A 2019 study in coastal Kenya demonstrated an incidence of 5.1 (95% confidence interval [CI], 2.6–9.8) per 100 person-years (PY) among GBMSM and 20.6 (95% CI, 6.6–63.8) per 100 PY among TGW [1]. Tailored approaches to engage people in HIV testing, by way of peer mobilisation, can help prevent HIV transmission among GBMSM and TGW if newly diagnosed participants can be linked to care and HIV negative participants initiated on PrEP [2–7].
Targeted testing approaches such as oral self-testing (OST) can reduce access barriers to testing among key and vulnerable populations [5,8]. While OST can diagnose chronic HIV infection, antibody self-tests perform poorly in diagnosing acute HIV infection (AHI) [9] AHI occurs during the first weeks after infection, characterised by a peak in viral load during which anti-HIV-1 antibodies are undetectable but HIV-1 RNA or p24 antigen are present [10–12]. It is estimated that 30–50% of onward transmission events occur during AHI [10,11,13,14]. Identifying individuals with AHI and immediately starting HIV treatment may substantially reduce onward HIV transmission [15].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2025 Shaun Palmer, Maartje Dijkstra, Alex Kigoro, Khamisi Mohamed, Nana Mukuria, Shally Mahmoud, Evanson Gichuru, Elise M van der Elst, Eduard J Sanders, Juan Pablo Gutierrez. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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