Study Protocol for Evaluation of The Impact of The Door-to-Door Approach by Community Health Workers and The Novel Mobile Application for Self-Reporting on HIV Testing Rates among Men-headed Households in Tanzania

Sub-Saharan Africa faces a disproportionate burden of HIV/AIDS, and Tanzania, reflecting this trend, faces challenges with only 60.6% of individuals aged 15–64 aware of their HIV status. Nevertheless, according to the present state of affairs, the mean coverage rate of previous HIV testing in Tanzania (66.5%) is still behind the UNAIDS target. The UNAIDS 2030 target urges a 95% awareness rate among those infected, sustained ARV therapy, and viral suppression. To address this, Tanzania amended its HIV and AIDS Act, permitting voluntary HIV self-testing. The Ministry of Health (MoH) initiated the distribution of oral HIV self-test kits, involving community health workers (CHWs). The Ifakara Health Institute (IHI) and their partners will conduct the operational research program. The main objective is to evaluate the impact of the door-to-door distribution of oral self-testing kits by community health workers and the novel mobile application for self-reporting HIV testing results among men-headed households in Tanzania.

The program is set to be implemented in four regions namely; Tabora, Kigoma, Manyara, and Kaskazini Pemba in Tanzania. These regions had low prior HIV testing rates among men. CHWs will conduct door-to-door distribution of HIV self-test kits to male-headed households, emphasizing the use of the novel mobile application for self-reporting results. In this operational research program, we will use a cluster randomized controlled trial with regions’ wards as the clusters to evaluate a well-defined intervention using a door-to-door approach and a mobile App within intervention wards in rural and urban communities. The sample size calculation considers regions’ population sizes and prior HIV testing rates, aiming to achieve an increase in self-testing. Ethical considerations will emphasize confidentiality, written informed consent, and careful monitoring of potential adverse outcomes, focusing on gender-based violence prevention. The program timeline spans 24 months, encompassing preparation, training, pilot testing, baseline, and subsequent surveys, with an emphasis on data analysis, report writing, and dissemination in the final phase.