Men's willingness to receive text messages and speak with an HIV counselor via the National HIV Hotline following HIV self-testing in Tanzania; a baseline cross- sectional analysis from a cluster -randomized controlled trial.

backgroundTanzania faces a significant burden of HIV, with challenges in reaching men and ensuring timely linkage to care. To address these issues, HIV self-testing (HIVST) has been implemented to increase HIV testing, and the National HIV Hotlines are being considered as a strategy to facilitate linkage to care. This study aimed to assess the willingness of Tanzanian men to receive support from use the National HIV Hotline via mobile phones for HIVST and linkage to care. This is the baseline cross-sectional analysis from a cluster randomized control trial (cRCT; NCT03891407), assessing men’s willingness to receive and speak with an HIV counselor via the National Hotline following HIVST.

methodsData from 505 men from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or “camps” in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. Logistic regression models were used to assess factors associated with men’s comfort with talking with an HIV counselor over the phone.

resultsThere were 505 heterosexual male participants enrolled in the study with an average age of 29 years. Most men reported being very comfortable talking to an HIV counselor n the National HIV Hotline (84.2%) and receiving text messages support from a hotline counselor (80.6%). Logistic regression demonstrated that comfortability texting a friend about HIV self-testing (OR = 3.37, 95% CI [1.97 – 5.76], being comfortable texting a friend about HIV (OR = 3.84, 95% CI [2.20 – 6.72], previous history of receiving HIV related text messages (aOR = 0.55, 95% CI [0.31 – 0.99] were significantly associated with men’s comfortability talking to a HIV counselor on the National HIV Hotline following HIVST. However, men with a previous history of receiving HIV-related text messages had lower odds of being very comfortable talking to a hotline counselor following HIVST (aOR = 0.59, 95% CI [0.34–1.01]. The factors such as participants’ comfortability texting friend about HIVST (OR = 2.52, 95% CI [1.49 – 4.25]) and comfortability texting friend about HIV (OR = 2.96, 95% CI [1.83 – 4.80] were significantly associated with the probability of participant’s comfortability receiving text message from HIV counselor following HIVST.

conclusionThe findings demonstrate that most men felt comfortable engaging with HIV counselors and receiving supportive text messages from the National HIV Hotline after self-testing. Comfort with hotline use was strongly associated with prior exposure to HIV-related SMS messages and willingness to discuss HIV or HIV self-testing with peers. These results underscore the feasibility of leveraging mobile health (mHealth) interventions to enhance user comfort, foster peer engagement, and facilitate tailored support for linkage to care following HIV self-testing.