Pilot Implementation of HIV Self-Testing Delivery in Private Pharmacies Combined With a Respondent-Driven Sampling Method to Improve HIV Testing for Men Who Have Sex With Men and Transgender Women in Phnom Penh (ANRS 0100s): Protocol for a Prospective Mixed Method Feasibility Study

Joseph LARMARANGE — 2025-06-27T09:45:00Z

Pilot Implementation of HIV Self-Testing Delivery in Private Pharmacies Combined With a Respondent-Driven Sampling Method to Improve HIV Testing for Men Who Have Sex With Men and Transgender Women in Phnom Penh (ANRS 0100s): Protocol for a Prospective Mixed Method Feasibility Study

Chhavarath Dary , Olivier Ségéral , Joseph Larmarange , Emilie Mosnier , Mohamed Ben Mechlia , Vichea Ouk , Bruno Spire , Vonthanak Saphonn

JMIR Research Protocols, 2025, 14, pp.e65351. ⟨10.2196/65351⟩

Article dans une revue

inserm-05471400

Authors

Chhavarath Dary, Olivier Ségéral, Joseph Larmarange, Emilie Mosnier, Mohamed Ben Mechlia, Vichea Ouk, Bruno Spire, Vonthanak Saphonn

Abstract

Background: Regular testing is recognized as a key strategy for HIV control. The 2023 Integrated Biological and Behavioral Survey (IBBS) in Cambodia revealed that nearly one-third of men who have sex with men (MSM) and one-fourth of transgender women (TGW) were never tested for HIV or not for more than 12 months. The majority of MSM and TGW were tested at community-based organizations (CBOs) facilities and by CBO outreach workers, while private facilities are poorly used for HIV testing (6% for MSM and 9% for TGW). Private pharmacies could be able to deliver HIV self-testing kits giving the advantage of confidentiality, anonymity, and time savings, in particular for those reluctant to visit CBOs. The recruitment of participants using a respondent-driven sampling method could provide the opportunity to reach MSM and TGW outside the network of CBOs.

Objective: This pilot study aims to evaluate the feasibility of free HIV self-testing delivery by a private pharmacy combined with a respondent-driven sampling method to improve HIV testing among MSM and TGW in Phnom Penh, Cambodia.

Methods: Both qualitative and quantitative approaches are used in this prospective feasibility study. The protocol was approved by the National Ethics Committee for Health Research in Cambodia (N0 351 NECHR). MSM and TGW aged more than 18 years old will be recruited via a respondent-driven sampling method with seeds recruited at hot spots and on social networks. The seeds will then distribute electronic and paper coupons to their networks physically and via social media, messaging, and calling applications. Each recruited peer will bring the coupon to receive direct and free access to one HIV self-testing kit at partner pharmacies as well as 10 additional coupons to recruit members of their networks. As for quantitative analysis, data from the study website will be imported, appended into a single matrix using Stata version 18SE (StataCorp), and analyzed using descriptive statistics, with a statistical significance level of .05. After 6 months, a qualitative assessment will be conducted among users, providers, and policymakers or key stakeholders to evaluate the acceptability and appropriateness of the strategy and to identify the barriers, facilitators, and recommendations. All transcripts will be analyzed according to the 6-phase reflexive thematic approach by Braun and Clarke. The results will be reported by participant-based and provider-based issues. QSR NVivo V.14 for Windows will be used to manage the data.

Results: The study was funded by Agence nationale de recherches sur le sida, les hépatites, et les maladies infectieuses émergentes (ANRS) in September 2023. Approval of the study protocol was successfully obtained from the NECHR in Cambodia and the Commission Nationale de l'Informatique et des Libertés (CNIL) in France (Autorisation Tacite) in February 2025. Data collection will be conducted between September 2024 and December 2025. The initial results are expected to be published in February 2026.

Conclusions: This public-private partnership intervention could allow the hidden population of MSM and TGW in Phnom Penh to be reached and tested.

Trial Registration: ClinicalTrials.gov NCT05745168; https://clinicaltrials.gov/study/NCT05745168

Pilot implementation of HIV self-testing delivery in private pharmacies combined to a Respondent Driven Sampling method to improve HIV testing for MSM and TGW in Phnom Penh

Joseph LARMARANGE — 2022-04-28T16:15:56Z

Pilot implementation of HIV self-testing delivery in private pharmacies combined to a Respondent Driven Sampling method to improve HIV testing for MSM and TGW in Phnom Penh – ANRS 0100s: a prospective feasibility study (Preprint)

Chhavarath Dary , Olivier Ségéral , Joseph Larmarange , Emilie Mosnier , Mohamed Ben Mechlia , Vichea Ouk , Bruno Spire , Vonthanak Saphonn

2024

Pré-publication, Document de travail

hal-04678769

Responsables scientifiques

SAPHONN Vonthanak (University of Health Sciences of Phnom Penh)
SPIRE Bruno (SESSTIM)

Partenariat

Financement

ANRS

Abstract

Primary objective

Evaluate the feasibility of HIV self-testing (HIVST) delivery by a private pharmacy network among men who have sex with men (MSM) and transgender women (TGW) recruited through a classic and digital Respondent Driven Sampling method to improve HIV testing in Phnom Penh, Cambodia

Secondary objectives

Evaluate the acceptability and appropriateness of the strategy
Identify barriers and facilitators
Estimate the linkage to confirmatory testing for those with a reactive test and linkage to HIV care and ART for those with a positive confirmatory HIV test
Estimate linkage to pre-exposure prophylaxis (PrEP) services for negative participants
Estimate the characteristics of participants and compare to those reported in Integrated Biological and Behavioral Survey (IBBS 2019) for MSM and TGW in Cambodia
Evaluate the adherence of participants to a 6-monthly repeated HIV testing

Methodology

An interventional pilot study using a mixed qualitative and quantitative approach will be carried out in order to evaluate the feasibility, acceptability and appropriateness of the strategy and to identify barriers and facilitators.

The participant recruitment method will be designed as a Respondent Driven Sampling (RDS) by recruiting initial seeds both at hotspots and on social networks. Prior to seed recruitment, a consultative meeting will be conducted in order to optimise the selection criteria of the seeds. The seeds will then distribute electronic and paper coupons to their networks physically and via social media, messaging and calling applications such as Twitter, Whatapp and Telegram (e-coupons). Each recruited participant will bring the coupon to be scanned at partner pharmacies to receive direct and free access to one HIVST kit. Partner pharmacies with a proper dedicated room/space securing privacy and secrecy in Phnom Penh are the study sites. There, trained community workers who get notified by partner at each visit of participant will do the study visit including information/consent, e-CRF filling and give a link of an external website to send the HIV test results and receive information or advices. These recruited individuals will be considered as wave 1 of recruitment and will each receive 10 additional coupons to recruit the members of their networks. The next round of individuals recruited and enrolled will be considered as wave 2, and so on.

After 6 months, a qualitative assessment via focus groups will be conducted among MSM, TGW and pharmacists to evaluate feasibility, acceptability and appropriateness of the intervention and to identify barriers and facilitators.

Several ART sites/HIV clinics particularly in charge of key populations will be specifically selected as participating centers in order to collect information on linkage to care or prevention services for positive and negative participants, respectively.

Each participant will be followed during 18 months and encouraged to perform a 6-monthly HIV testing during this period.

Expected enrolment

A pragmatic approach is carried out in which the enrolment will be stopped at the end of the inclusion period or if the number of participants reaches a maximum of 1500.

Zone géographique

Phnom Penh, Cambodge

Calendrier

2022-2024