Trial reportBMJ global health2021
Comparison of community-led distribution of HIV self-tests kits with distribution by paid distributors: a cluster randomised trial in rural Zimbabwean communities.
Trial report in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- ART initiations following community-based distribution of HIV self-tests: meta-analysis and meta-regression of STAR Initiative data.BMJ global health · 2021Pooled it
- A process evaluation of community-led distribution of HIV self-testing kits in rural communities in Zimbabwe.Health policy and planning · 2026Trial
- Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe.BMC infectious diseases · 2023Trial
- Developing and evaluating a community-driven intervention to promote uptake of HIV and contraception services among students enrolled in colleges and universities in Zimbabwe.Journal of the International AIDS Society · 2025Article
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Community-led strategies for communicable disease prevention and management in low- and middle- income countries: A mixed-methods systematic review of health, social, and economic impact.PLOS global public health · 2025Article
- Do community-level factors play a role in HIV self-testing uptake, linkage to services and HIV-related outcomes? A mixed methods study of community-led HIV self-testing in rural Zimbabwe.PLOS global public health · 2025Article
- Who has never tested for HIV following a community-based distribution of HIV self-test kits? Establishing associated predictors in rural Zimbabwe.PLOS global public health · 2025Article
- Provider costs of professional COVID-19 rapid antigen testing in low-income settings.PLOS global public health · 2025Article
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Strategies for implementing HIV self-testing in diverse populations: an integrative review.Revista brasileira de enfermagem · 2025Review
- Cost-effectiveness analysis of community-led HIV self-testing among key populations in Côte d'Ivoire, Mali, and Senegal.Journal of the International AIDS Society · 2024Article
- Feasibility, acceptability and preliminary effect of a community-led HIV self-testing model among adolescent girls and young women in Rural Northern Uganda: a quasi-experimental study protocol.Implementation science communications · 2024Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
backgroundWe compared community-led versus an established community-based HIV self-testing (HIVST) model in rural Zimbabwe using a cluster-randomised trial.
methodsForty village groups were randomised 1:1 using restricted randomisation to community-led HIVST, where communities planned and implemented HIVST distribution for 4 weeks, or paid distribution (PD), where distributors were paid US$50 to distribute kits door-to-door over 4 weeks. Individual level primary outcomes compared household survey responses by arm 4 months post-intervention for: (1) newly diagnosed HIV during/within 4 months following HIVST distribution, (2) linkage to confirmatory testing, pre-exposure prophylaxis or voluntary medical male circumcision during/within 4 months following HIVST distribution. Participants were not masked to allocation; analysis used masked data. Trial analysis used random-effects logistic regression.Distribution costs compared: (1) community-led HIVST, (2) PD HIVST and (3) PD costs when first implemented in 2016/2017.
resultsFrom October 2018 to August 2019, 27 812 and 36 699 HIVST kits were distributed in community-led and PD communities, respectively. We surveyed 11 150 participants and 5683 were in community-led arm. New HIV diagnosis was reported by 211 (3.7%) community-led versus 197 (3.6%) PD arm participants, adjusted OR (aOR) 1.1 (95% CI 0.72 to 1.56); 318 (25.9%) community-led arm participants linked to post-test services versus 361 (23.9%) in PD arm, aOR 1.1 (95% CI 0.75 to 1.49.Cost per HIVST kit distributed was US$6.29 and US$10.25 for PD and community-led HIVST, both lower than 2016/2017 costs for newly implemented PD (US$14.52). No social harms were reported.
conclusionsCommunity-led HIVST can perform as well as paid distribution, with lower costs in the first year. These costs may reduce with programme maturity/learning. TRIAL REGISTRATION NUMBER: PACTR201811849455568.
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