Findings From the Todurujo na Kadurok (Empowering Youth) HIV Self-Testing and Edutainment Comic Randomized Controlled Trial With Refugee Youth in a Humanitarian Setting in Uganda

Carmen H Logie; Miranda G Loutet; Moses Okumu; Frannie MacKenzie; Madelaine Coelho; Simon Odong Lukone; Nelson Kisubi; Aiman Malhi; Peter Kyambadde; Lawrence Mbuagbaw

doi:10.1177/23259582241307057

Findings From the Todurujo na Kadurok (Empowering Youth) HIV Self-Testing and Edutainment Comic Randomized Controlled Trial With Refugee Youth in a Humanitarian Setting in Uganda

J Int Assoc Provid AIDS Care. 2024 Jan-Dec:23:23259582241307057. doi: 10.1177/23259582241307057.

Authors

Carmen H Logie^{1

2

3}, Miranda G Loutet⁴, Moses Okumu^{5

6}, Frannie MacKenzie¹, Madelaine Coelho⁷, Simon Odong Lukone⁸, Nelson Kisubi⁸, Aiman Malhi¹, Peter Kyambadde^{9

10}, Lawrence Mbuagbaw^{11

12

13

14}

Affiliations

¹ Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
² Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada.
³ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
⁴ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁵ School of Social Work, University of Illinois at Urbana Champaign, Urbana, IL, USA.
⁶ School of Social Sciences, Uganda Christian University, Mukono, Uganda.
⁷ Department of Sociology, University of Toronto, Toronto, ON, Canada.
⁸ Uganda Refugee and Disaster Management Council (URDMC), Arua, Uganda.
⁹ National AIDS Coordinating Program, Ugandan Ministry of Health, Kampala, Uganda.
¹⁰ Most at Risk Population Initiative (MARPI), Kampala, Uganda.
¹¹ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
¹² Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada.
¹³ Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon.
¹⁴ Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa.

Abstract

Introduction: Humanitarian settings are underserved by HIV self-testing (HIV-ST).

Methods: We conducted a randomized controlled trial to evaluate the effectiveness of HIV-ST (Arm 1), HIV-ST alongside edutainment comics (Arm 2), and edutainment comics (Arm 3), compared with the standard of care (SOC), in increasing HIV testing with refugee youth aged 16-24 in the Bidi Bidi Refugee Settlement, Uganda. Intervention effects on HIV testing at 3-month follow-up (T2) were assessed using generalized estimating equation models alongside open-ended questions.

Results: Retention was 98% (n = 117/120) at T2. In adjusted analyses compared with the SOC, HIV testing changes from baseline to T2 were highest in Arm 2 (adjusted odds ratio [aOR]: 8.46; 95% confidence interval [CI]: 2.87-24.97), followed by Arm 3 (aOR: 4.14; 95% CI: 1.58-10.87), with no significant differences in Arm 1.

Conclusion: HIV self-testing is feasible for refugee youth in Uganda and can be supplemented with edutainment comics to advance HIV prevention efforts.

Keywords: HIV self-testing; Uganda; edutainment comics; intervention; refugees; youth.

Plain language summary

Findings from an HIV self-testing and comic intervention with refugee youth in a humanitarian setting in Uganda.

Publication types

Randomized Controlled Trial

MeSH terms

Adolescent
Altruism
Female
HIV Infections* / diagnosis
HIV Testing / methods
HIV Testing / statistics & numerical data
Humans
Male
Mass Screening / methods
Mass Screening / statistics & numerical data
Refugees* / statistics & numerical data
Self-Testing*
Uganda
Young Adult