Reaching young men through HIV self-testing at the workplace in Mozambique

HIV self-testing has proven to offer unique opportunities to reach workers, their families and communities with HIV testing services in locations where they spend most of their daily lives, the workplace. In order to bring these services to men who would otherwise not attend health centers, a project of HIV self-testing was implemented in formal and informal workplaces in Mozambique, focusing on male-dominated sectors and companies.

HIV self-testing under the VCT@WORK Initiative is a great opportunity for our members and their clients to get tested and also to receive HIV related services in the informal workplace.

Ramos Marrengula, Informal Sector Association (AEIMO)

The ILO worked with the Ministry of Health, the HIV Business Coalition (ECoSIDA), the Population Services International (PSI), employers’ and workers’ organizations under the Unitaid - supported STAR Phase three project.

HIV self-testing was implemented during 2021 and mid of 2022 in Maputo, Sofala, Tete and Nampula provinces, in workplaces for workers and their families.

The project was implemented primarily in transport and construction sectors, focusing on young men.

A network of peer educators and health workers were trained who created demand, organized awareness events, distributed HIV self-test kits and followed up with workers to help them connect with confirmatory tests, treatment and care as needed.

Awareness events on HIV and AIDS, focussing on reducing stigma and discrimination, benefits of HIV testing, and use of self-test kits were organized in small and medium-sized enterprises, in informal markets and informal settings reaching local communities. ECoSIDA also involved the health units in the areas where the health campaigns took place, so that they could provide technical support and follow-up on the cases that were referred to the health units. The workers' organizations (OTM-CS and CONSILMO) were key players in mobilizing workers to participate in the self-testing sessions.

Peer educators followed up with participants who took an HIV self-test kit through phone calls. Some workers opted for assisted HIV self-testing, who were helped by peer educators.

The implementation of a monitoring and evaluation plan designed by the Ministry of Health, PSI, ECoSIDA and ILO provided data that facilitated information gathering and ensured informed decisions about the programme design and implementation. All indicators were aligned with the National Strategic Plan for HIV.

ILO ran a social media campaign together with constituents to promote HIV self-testing at the workplace.

HIV self-testing is a way to take care of the health of the worker, the most precious resource in the production of wealth in a company. I encourage all workers to make use of it, know your HIV status and live positively.

Helena Ferro, Business Coalition Against AIDS (ECOSIDA)

• A total of 42,065 HIV self-test kits were distributed, 60 per cent to workers, 28 per cent to their partners and 12 per cent to communities surrounding workplaces.
• Men were predominantly reached. 85 percent of those taking an HIV self-test were young men, primarily between 20 and 35 years of age.
• 58 per cent of the male workers who took an HIV self-test had not tested for more than 12 months
• and 15 per cent were first-time testers. Among young men between 18 and 29 years of age, 20 per cent were first-time testers.
• A total of 457 people reported back a reactive HIV test result (1,3 per cent men and 1,7 percent women). 79 per cent reported having done confirmatory testing and 88 per cent of these were linked to receive antiretroviral treatment.
• Workers, their families, and community members indicated that the levels of trust for HIV testing have increased because the HIV self-testing approach guarantees more confidentiality.

• Self-testing at workplace reduces stigma and discrimination and it is convenient for workers.
• Self-testing, implemented in a male-dominated sectors, results in reducing HIV testing gap amongst men.
• HIV self-testing allows for reaching young men, first time testers as well as those who don’t test too often.
• Peer educators were important in motivating workers to test for HIV. Peer educators need to be regularly training and recognized for their work by their management.
• Even though the focus was on male workers, the project also covered women, who also found it convenient to use self-test kits.
• ECoSIDA, as a business coalition, and ASSOTSI were able to engage with and reach a diversity of workplaces of both formal and informal workers and small and medium sized enterprises.

After successful completion of this pilot phase, ECoSIDA was selected by the Ministry of Health with support of the Global Fund to Fight AIDS, Tuberculosis and Malaria and ILO Mozambique to scale up HIV self-testing distribution countrywide. ECoSIDA now employs now 68 trained HIV self-testing counsellors and distributors in 38 districts in Mozambique.