HIVST in fishing communities: the man, the provider, the kit

Adolescent and young men in fishing communities resist provider-administered testing — partly out of privacy concerns, partly because clinic-style booths at a landing site mark the user out to peers. HIV self-testing (HIVST) sidesteps both barriers.

In 2024 the team distributed 2,400 OraQuick HIVST kits at fishing landing sites across Kilwa and Lindi District, with structured peer-led pre-test counselling and a clear post-test follow-up pathway.

One thousand eight hundred and forty kit recipients (77 percent) returned for follow-up contact within fourteen days, either in person or by structured phone call. Ninety-four reported reactive results; eighty-nine (95 percent) accepted confirmatory testing.

Confirmed positives were linked to ART within seven days, with a discreet referral pathway agreed with two facility in-charges that allows a young man to walk into the clinic for an unrelated reason and quietly initiate.

HIVST distribution is logistically simple but counselling-intensive. Sustaining quality at scale requires ongoing peer supervision, a robust kit accountability system, and a respectful follow-up rhythm that never tips into surveillance.