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Recruiting the social contacts of patients with STI for HIV screening in Lilongwe, Malawi: process evaluation and assessment of acceptability
  1. Nora E Rosenberg1,2,3,
  2. Christopher C Stanley1,
  3. Sarah E Rutstein3,4,
  4. Naomi Bonongwe1,
  5. Gift Kamanga1,4,
  6. Audrey Pettifor2,
  7. Clement Mapanje1,
  8. Francis Martinson1,3,
  9. Irving F Hoffman1,3,
  10. William C Miller2,3
  1. 1UNC Project, UNC Chapel Hill, Lilongwe, Malawi
  2. 2Department of Epidemiology, UNC Chapel Hill, Chapel Hill, North Carolina, USA
  3. 3Department of Medicine, UNC Chapel Hill, Chapel Hill, North Carolina, USA
  4. 4Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Nora E Rosenberg, University of North Carolina Project, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi; Nora_Rosenberg{at}unc.edu

Abstract

Objectives To explore acceptability of recruiting social contacts for HIV and sexually transmitted infection (STI) screening in Lilongwe, Malawi.

Methods In this observational study, three groups of ‘seed’ patients were enrolled: 45 HIV-infected patients with STI, 45 HIV-uninfected patients with STI and 45 community controls, who were also tested for HIV as part of the study. Each seed was given five coupons and asked to recruit up to five social contacts to the STI clinic. Seeds were told the programme for contacts would include HIV testing, STI screening and general health promotion. Seeds were asked to return after 1 month to report on the contact recruitment process. Seeds received $2 for each successfully recruited contact.

Results Eighty-nine seeds (66%) returned for 1-month follow-up with no difference between the three seed groups (p=0.9). Returning seeds reported distributing most of their coupons (mean=4.1) and discussing each feature of the programme with most contacts—HIV testing (90%), STI screening (87%) and health promotion (91%). Seeds reported discussing their own HIV status with most contacts (52%), with a lower proportion of HIV-infected seeds discussing their HIV status (22%) than HIV-uninfected seeds (81%) or community seeds (64%) (p<0.001). Contact recruitment did not vary with socioeconomic status.

Conclusions Most seeds distributed all coupons and reported describing all aspects of the programme to most contacts. Patients with STI are able to act as health promoters within their social networks and may be a critical link to increasing STI and HIV status awareness among high-risk groups.

  • HIV
  • PREVENTION
  • SEXUAL NETWORKS
  • SOCIAL SCIENCE
  • AFRICA

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