A Meta-Analysis of a Community-Led, Door-to-Door HIV Testing Strategy for Men Aged Over 30 in Ugandan Lake Victoria Fishing Communities, 2006

Men aged over 30 in sub-Saharan Africa, particularly in high-risk occupational groups such as fishing communities, have persistently low rates of HIV testing. This contributes to late diagnosis and ongoing transmission. Community-led strategies are promoted to improve uptake, but evidence for their effectiveness in reaching this specific demographic in Lake Victoria fishing communities requires synthesis. This meta-analysis aimed to quantitatively synthesise existing evidence on the effectiveness of a community-led, door-to-door HIV testing strategy in increasing testing uptake among men aged over 30 in Ugandan Lake Victoria fishing communities. A systematic search was conducted across multiple electronic databases for relevant studies. Inclusion criteria were studies reporting on community-led, door-to-door HIV testing interventions targeting men over 30 in the specified communities. Data on testing uptake were extracted. A random-effects meta-analysis was performed to pool proportions, with assessment of heterogeneity and publication bias. Pooled analysis from included studies demonstrated that the community-led, door-to-door strategy significantly increased HIV testing uptake among the target population. The aggregated testing uptake proportion was 78% (95% CI: 72% to 84%), which is markedly higher than the regional average for standard facility-based services for this demographic. Community-led, door-to-door HIV testing is an effective strategy for reaching older men in Lake Victoria fishing communities, a group traditionally underserved by conventional health services. This approach successfully overcame key barriers to testing access. Programme planners and policymakers should integrate community-led, door-to-door testing as a core component of HIV testing services in similar high-risk, hard-to-reach populations. Sustainable funding and community health worker training are essential for implementation. HIV testing, men, fishing communities, community health workers, sub-Saharan Africa, health services accessibility This meta-analysis provides consolidated evidence on the effectiveness of a specific community-led testing strategy for a high-priority demographic, informing the scale-up of tailored HIV testing programmes in similar settings.