Testing a Push-Pull model: community-based dissemination of oral HIV self-testing

Area of Science:

• Public Health
• Health Innovation Dissemination
• Community-Based Interventions

Background:

• The Push-Pull-Infrastructure (PPI) model is a strategy for disseminating health innovations.
• A community-based intervention was developed to disseminate oral human immunodeficiency virus (HIV) self-testing (OHST) to men who have sex with men (MSM) in Portland, OR, using the PPI model.

Purpose of the Study:

• To examine the feasibility of a community-based intervention to disseminate oral HIV self-testing (OHST) to MSM.
• To evaluate the effectiveness of the Push-Pull-Infrastructure (PPI) model in a real-world setting.

Main Methods:

• OHST kits were disseminated through a network of 6 commercial businesses serving the LGBTQ+ community.
• Weekly data on kit distribution were collected, and street intercepts assessed customer awareness of promotional efforts.
• A quasi-experimental design examined the impact of promotional intensity on OHST dissemination.

Main Results:

• Over 24 weeks, 2698 OHST kits were disseminated.
• Dissemination rates showed a dose-response relationship with promotional campaign intensity.
• Customer awareness increased significantly, from 22% to 60% within 9 weeks (P < .001).
• Dissemination rates were comparable to or exceeded other county-level HIV testing programs.

Conclusions:

• The PPI model, utilizing a community commercial network, proved highly successful in disseminating OHST.
• The promotional component effectively increased customer awareness of the intervention.
• Further research is warranted on optimizing promotional strategies for greater impact with fewer resources.