Men who have sex with men in Kenya experience a disproportionate burden of HIV and encounter barriers to conventional testing, such as stigma. Peer-led interventions are promising for key populations, but evidence on the effectiveness of peer-led HIV self-testing distribution for this group in urban Kenya requires synthesis. This meta-analysis aimed to synthesise quantitative evidence on the effectiveness of a peer-led HIV self-testing distribution model for increasing HIV testing uptake and case identification among men who have sex with men in Mombasa, Kenya. A systematic search was conducted across major electronic databases. Included studies were randomised controlled trials, quasi-experimental studies, and observational studies evaluating peer-led HIV self-testing distribution for this population in Mombasa. Data on testing uptake, positivity rates, and linkage to care were extracted. Pooled effect estimates were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic. Three studies met the inclusion criteria. Pooled results indicated that peer-led distribution significantly increased testing uptake compared to standard facility-based testing (odds ratio 2.45, 95% CI 1.88–3.19). The pooled HIV positivity rate among those tested via this model was 8.7%. Peer-led distribution of HIV self-testing kits is an effective strategy for increasing HIV testing coverage and case finding among men who have sex with men in Mombasa, reaching a population often marginalised by traditional services. Programme planners and policymakers should integrate and scale up peer-led HIV self-testing distribution within comprehensive HIV prevention packages for men who have sex with men in similar urban settings. Further research should focus on optimising linkage to confirmatory testing and care. HIV self-testing, peer-led, men who have sex with men, key populations, Kenya, meta-analysis. This meta-analysis provides consolidated evidence on the effectiveness of a peer-led HIV self-testing model for men who have sex with men in an urban Kenyan setting, informing public health strategy and policy.
Njeri Sarah Wanjiku (Thu,) studied this question.