In Uganda’s remote fishing communities, HIV prevalence remains high while healthcare access is limited. Dr Joseph Matovu, public health researcher and AfOx Fellow, is tackling this challenge through a peer-led intervention called PEST4MEN (Peer-led HIV Self-Testing for Men). His innovative model trains respected community members to distribute HIV self-test kits and support peers through the testing process.
The results have been promising: in 2022 alone, 99% of 355 men who received self-test kits from peer-leaders reported using them. Nearly one-third of those testing HIV-positive were first-time testers, and 70% were successfully linked to care. These outcomes demonstrate how trust-based, community-led models can improve health outcomes in highly mobile, underserved populations.
The initiative builds on earlier experience from the Game Changers for HIV Prevention Project, led by Dr Laura Bogart at the RAND Corporation, where peer influence proved more impactful than traditional outreach. With support from the AfOx, Dr Matovu is now scaling the model in partnership with Dr Adrian Smith from the Nuffield Department of Population Health.
The next phase will include formative research, co-creation of an intervention tailored to the mobility of fisherfolk, and a pilot study. These efforts aim to inform a future hybrid implementation-effectiveness trial and explore integration with Uganda’s village health teams.
AfOx support has also expanded Dr Matovu’s academic network, enabling collaborations across Oxford colleges and departments. As the project grows, it stands as a scalable, sustainable model for HIV prevention, one rooted in trust, equity, and community leadership.
“This is about more than just HIV testing,” says Dr Matovu. “It’s about empowering communities, building trust, and creating health solutions that people can own.”
The PEST4MEN model offers a compelling path forward, not only for Uganda but for similar high-risk populations globally.