Researchers conducted a randomized controlled trial involving adolescent girls and young women aged 16 to 24 years in Central Kenya. The study compared an enhanced peer referral approach, which included group training on referral strategies and the delivery of HIV self-testing kits, against standard informal peer referral methods. A total of 82 index peers were randomized to either the enhanced or standard groups, with data also collected on 241 referred peers.
The main results showed no significant difference in PrEP initiation between the two groups. Only 30% of those in the enhanced group started PrEP compared to 41% in the standard group. Similarly, there was no association found regarding the continuation of PrEP use at the one-month refill mark. However, the enhanced group did show a significant increase in HIV testing compared to the standard group.
Safety was generally acceptable, with both groups finding the enhanced referral feasible. However, two instances of verbal abuse were reported among the index peers. The study relies on index peers to report outcomes for the people they referred, which is a key limitation. While the enhanced method did not improve PrEP uptake, the increase in HIV testing suggests that combining peer-delivered self-testing with other strategies could help improve engagement for this population.