Overcoming cultural barriers to implementing oral HIV self-testing with high fidelity among Tanzanian youth.


Catania JA(1), Huun C(2), Dolcini MM(1), Urban AJ(1), Fleury N(1), Ndyetabula C(3), Singh R(1), Young AW(1), Conserve DF(4), Lace J(3), Msigwa JS(3).
Author information:
(1)Hallie E. Ford Center, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
(2)Oregon Health Sciences University, Portland, OR, USA.
(3)FASDO, Yatima Group Fund, Tanzania.
(4)University of South Carolina, Columbia, SC, USA.


Tanzanian youth have high levels of HIV risk and poor access to HIV-testing. Oral self-implemented testing (Oral-SIT) provides an alternative that reduces barriers to HIV-testing. We examined adaptations to Oral-SIT training components in a randomized experiment to evaluate a "train-the-trainer" strategy for improving comprehension of graphic training materials. Participants (N = 257, age = 14-19 years) were randomly assigned to one of two self-training conditions: graphic instruction book (GIB) or Video-GIB. Outcomes included behavioral performance fidelity, self-reported comprehension, and intentions to seek treatment. Video-GIB participants, relative to GIB-only participants, had higher performance fidelity scores, made fewer performance errors, had better instruction comprehension, and were more likely to intend to seek treatment. Oral-SIT timing errors were significantly more common among GIB-only participants. Graphic training materials in conjunction with a "train-the-trainer" video has significant potential for increasing Oral-SIT's reach by overcoming technological and literacy barriers.