Background HIV self-testing (HIVST) can improve HIV testing rates among highly mobile populations including the male-fisherfolk, but this is not well documented. We assessed HIVST uptake and linkage to HIV care among male fisherfolk in rural Uganda.

Methods The peer-led HIVST intervention for men (PEST4MEN) was conducted among male fisherfolk in two fishing communities in Kalangala and Buvuma island districts in central Uganda, between July and September 2022. Before intervention implementation, 22 men were selected from existing social network groups and trained to serve as male HIV self-test kits distributors or “peer-leaders”. Each peer-leader was then requested to nominate up to 20 men from their social networks, who were screened for eligibility and administered a baseline interview if they were eligible. Eligible men had to be 15+ years, self-report a HIV-negative or unknown HIV status and not tested for HIV at least three months prior to enrolment. After the baseline visit, men obtained free oral HIV self-test kits from their peer-leaders and used them to self-test for HIV. We assessed uptake of HIVST and linkage to HIV care among first-time HIV-positive testers using STATA (version 16.0).

Results Of 475 men screened for study eligibility, 400 (84%) were eligible and administered a baseline interview. Ninety percent (361) completed a follow-up interview. Of these, 98.3% (355) obtained at least one kit from their peer-leaders; 99.1% (352) used them to self-test for HIV. Of the 352 self-testers, 9.4% (33) tested HIV-positive; 81.8% (27) were first-time HIV-positive testers. Of the 27 first-time HIV-positive testers; 40.7% (11) went for confirmatory HIV testing, 10 were confirmed as HIV-positive and 9 were linked to HIV care.

Conclusion Our peer-led HIVST intervention achieved high rates of HIV testing uptake and identified a high proportion of previously undiagnosed HIV-positive male fisherfolk but linkage to confirmatory HIV testing was sub-optimal.