{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:44:49Z","timestamp":1785854689209,"version":"3.56.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kenya continues to experience persistent gender disparities in HIV testing. Young men remain substantially less likely than young women to test for HIV, despite expansion of facility based, community based, and HIV self testing services. Although WhatsApp based and peer led interventions have shown promise individually, it remains unclear whether adding online peer influencer engagement to standard HIV communication further increases HIV testing uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether adding an online peer influencer led WhatsApp intervention to standard FM radio and WhatsApp HIV messaging increases HIV testing uptake among young adult men aged 18\u201332\u202fyears in Nairobi, Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A three-arm, age-stratified randomized controlled trial (1:1:1 allocation) will recruit young adult men aged 18\u201332\u202fyears online in Nairobi. Participants will receive either (i) FM radio HIV messaging, (ii) FM radio plus standard WhatsApp HIV messaging, or (iii) FM radio plus WhatsApp messaging with an online peer influencer intervention. Participants will be followed for 12\u202fweeks. The primary outcome is verified HIV testing uptake, defined as completion of at least one HIV test during follow up and confirmed through participant self report, de-identified facility records, and a Unique Referral Identification Code (URIC). Primary analyses will use generalized linear mixed models under an intention-to-treat framework, with prespecified secondary analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial addresses an important evidence gap by evaluating the added value of online peer influencers in increasing verified HIV testing uptake among young adult men in Nairobi, beyond standard radio and WhatsApp HIV messaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Findings will provide rigorous evidence to inform HIV testing policies and scalable digital behavior change interventions targeting young men in Nairobi and similar urban settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/pactr.samrc.ac.za\/Researcher\/ManageTrials_v2.aspx<\/jats:ext-link>\n                      , Identifier PACTR202605857599507.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1871838","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:44:41Z","timestamp":1785851081000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Can online peer influencers accelerate HIV testing among young adult males living in Nairobi, Kenya? A study protocol"],"prefix":"10.3389","volume":"14","author":[{"given":"Arnold C.","family":"Wafula","sequence":"first","affiliation":[{"name":"Department of Environmental Health and Disease Control, School of Public Health, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology (JKUAT)","place":["Nairobi, Kenya"]},{"name":"KEMRI Graduate School, School of Public Health, Kenya Medical Research Institute (KEMRI), Centre for Respiratory Disease Research","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evans","family":"Amukoye","sequence":"additional","affiliation":[{"name":"KEMRI Graduate School, School of Public Health, Kenya Medical Research Institute (KEMRI), Centre for Respiratory Disease Research","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Ngure","sequence":"additional","affiliation":[{"name":"Department of Environmental Health and Disease Control, School of Public Health, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology (JKUAT)","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref1","volume-title":"Global HIV Update 2025","year":"2025"},{"key":"ref2","volume-title":"Kenya HIV Estimates Report 2025","year":"2025"},{"key":"ref3","first-page":"145","article-title":"Barriers to HIV testing among young men in Kenya","volume":"26","author":"Lilian","year":"2026","journal-title":"BMC Public Health"},{"key":"ref4","first-page":"876","article-title":"Barriers to HIV testing among men in Kenya","volume":"23","author":"Onsomu","year":"2023","journal-title":"BMC Public Health"},{"key":"ref5","first-page":"e51234","article-title":"Effectiveness of digital HIV interventions among youth in sub-Saharan Africa","volume":"26","author":"Kombo","year":"2024","journal-title":"J Med Internet Res"},{"key":"ref6","volume-title":"Health Act (No. 21 of 2017)","year":"2017"},{"key":"ref7","volume-title":"Kenya HIV Estimates Report 2025","year":"2025"},{"key":"ref8","volume-title":"First quarter sector Statistics Report for the Financial year 2024\/2025","year":"2025"},{"key":"ref9","year":"2025"},{"key":"ref10","volume-title":"WhatsApp Usage Statistics in Kenya","year":"2025"},{"key":"ref11","volume-title":"Kenya Population Report","year":"2026"},{"key":"ref12","article-title":"State of Kenya Population Report","volume-title":"National Commission for Population and Development (NCPD)","year":"2024"},{"key":"ref13","first-page":"e1004215","article-title":"Effect of a WhatsApp-based intervention on HIV testing uptake","volume":"20","author":"Ronen","year":"2023","journal-title":"PLoS Med"},{"key":"ref14","first-page":"e669","article-title":"Social network\u2013based HIV interventions in Kenya","volume":"13","author":"Sheira","year":"2025","journal-title":"Lancet Glob Health"},{"key":"ref15","first-page":"e210","article-title":"Peer-led HIV testing interventions in sub-Saharan Africa","volume":"14","author":"Otambo","year":"2026","journal-title":"Lancet Glob Health"},{"key":"ref16","first-page":"e25789","article-title":"Peer-led HIV interventions and testing uptake","volume":"24","author":"Smith","year":"2021","journal-title":"J Int AIDS Soc"},{"key":"ref17","first-page":"178","article-title":"Regression models for repeated measures","volume":"32","author":"Carlin","year":"2013","journal-title":"Stat Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"200","DOI":"10.7326\/0003-4819-158-3-201302050-00583","article-title":"SPIRIT 2013 statement: defining standard protocol items for clinical trials","volume":"158","author":"Chan","year":"2013","journal-title":"Ann Intern Med"},{"key":"ref20","volume-title":"Kenya Master Health Facility List","year":"2026"},{"key":"ref21","first-page":"e412","article-title":"Digital-to-clinic HIV intervention models","volume":"9","author":"Tun","year":"2022","journal-title":"Lancet HIV"},{"key":"ref22","volume-title":"Sampling Techniques","author":"Cochran","year":"1963"},{"key":"ref23","doi-asserted-by":"crossref","DOI":"10.1002\/9781119513469","volume-title":"Applied Longitudinal Analysis","author":"Fitzmaurice","year":"2011"},{"key":"ref24","volume-title":"Global AIDS Update 2024","year":"2024"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1126\/science.1217330","article-title":"Network interventions","volume":"337","author":"Valente","year":"2012","journal-title":"Science"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1136\/bmj.322.7282.355","article-title":"Contamination in trials","volume":"322","author":"Torgerson","year":"2001","journal-title":"BMJ"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"295","DOI":"10.7326\/0003-4819-148-4-200802190-00008","article-title":"Extending the CONSORT statement to randomized trials of nonpharmacologic treatment","volume":"148","author":"Boutron","year":"2007","journal-title":"Ann Intern Med"},{"key":"ref28","volume-title":"International Ethical Guidelines for Health-Related Research Involving Humans","year":"2016"},{"key":"ref29","first-page":"e27630","article-title":"Digital health interventions and measurement approaches","volume":"23","author":"Haber","year":"2021","journal-title":"J Med Internet Res"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"160018","DOI":"10.1038\/sdata.2016.18","article-title":"The FAIR guiding principles for scientific data management","volume":"3","author":"Wilkinson","year":"2016","journal-title":"Sci Data"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/1748-5908-2-40","article-title":"A conceptual framework for implementation fidelity","volume":"2","author":"Carroll","year":"2007","journal-title":"Implement Sci"},{"key":"ref32","first-page":"12","article-title":"Systematic review of retention strategies","volume":"8","author":"Robinson","year":"2007","journal-title":"Trials"},{"key":"ref33","volume-title":"Data Protection Act (No. 24 of 2019)","year":"2019"},{"key":"ref34","volume-title":"General Data Protection Regulation (GDPR)","year":"2016"},{"key":"ref35","volume-title":"Integrated Addendum to ICH E6(R2): Guideline for Good Clinical Practice","year":"2016"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"109","DOI":"10.4103\/2229-3485.83221","article-title":"Intention-to-treat concept: a review","volume":"2","author":"Gupta","year":"2011","journal-title":"Perspect Clin Res"},{"key":"ref37","doi-asserted-by":"crossref","DOI":"10.1002\/9781118548387","volume-title":"Applied Logistic Regression","author":"Hosmer","year":"2013"},{"key":"ref38","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond","year":"2015"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"c869","DOI":"10.1136\/bmj.c869","article-title":"CONSORT 2010 explanation and elaboration","volume":"340","author":"Moher","year":"2010","journal-title":"BMJ"},{"key":"ref40","first-page":"1123","article-title":"Gender disparities in HIV infection and testing among youth in Kenya","volume":"23","author":"Abuya","year":"2023","journal-title":"BMC Public Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1287\/orsc.1100.0641","article-title":"On network theory","volume":"22","author":"Borgatti","year":"2011","journal-title":"Organ Sci"},{"key":"ref42","volume-title":"Statistical Methods for Rates and Proportions","author":"Fleiss","year":"2013"},{"key":"ref43","volume-title":"Global Digital Behavior Report","year":"2025"},{"key":"ref44","volume-title":"Designing Clinical Research","author":"Hulley","year":"2013"},{"key":"ref45","volume-title":"Statistical Analysis with Missing Data","author":"Little","year":"2019"},{"key":"ref46","first-page":"221","article-title":"Social network interventions in health behavior","volume":"105","author":"Latkin","year":"2015","journal-title":"Am J Public Health"},{"key":"ref47","volume-title":"Global Social Media Usage Report 2026","year":"2026"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1471-2288-13-92","article-title":"A tutorial on sensitivity analyses","volume":"13","author":"Thabane","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"ref49","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9781139342834","volume-title":"Applied Longitudinal Data Analysis for Epidemiology","author":"Twisk","year":"2013"},{"key":"ref50","volume-title":"Ethics and Governance of Digital Health Research","year":"2021"},{"key":"ref51","year":"2023","journal-title":"Kenya Health Facility Census Report"},{"key":"ref52","first-page":"101","article-title":"Social media interventions to prevent HIV: a review of efficacy and delivery modes","volume":"16","author":"Hightow-Weidman","year":"2019","journal-title":"Sex Health."},{"key":"ref53","first-page":"256","article-title":"Barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide: a systematic review","volume":"71","author":"Chory","year":"2022","journal-title":"J Adolesc Health."},{"key":"ref54","year":"2022","journal-title":"First Quarter Sector Statistics Report for the Financial Year 2022\/2023"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"143","DOI":"10.11613\/BM.2013.018","article-title":"The McNemar test for binary matched-pairs data","volume":"23","author":"McHugh","year":"2013","journal-title":"Biochem Med (Zagreb)."},{"key":"ref56","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1136\/bmj.2.4582.769","article-title":"Streptomycin treatment of pulmonary tuberculosis: a Medical Research Council investigation","volume":"2","year":"1948","journal-title":"BMJ."},{"key":"ref57","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/MLR.0b013e3182408812","article-title":"Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact","volume":"50","author":"Curran","year":"2012","journal-title":"Med Care."},{"key":"ref58","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/BF02295996","article-title":"Note on the sampling error of the difference between correlated proportions or percentages","volume":"12","author":"McNemar","year":"1947","journal-title":"Psychometrika."},{"key":"ref59","first-page":"e92381","article-title":"Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries: a systematic review and meta-analysis","volume":"9","author":"Fonner","year":"2014","journal-title":"PLoS One."},{"key":"ref60","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials","volume":"340","year":"2010","journal-title":"BMJ."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1871838\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:44:49Z","timestamp":1785851089000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1871838\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":60,"alternative-id":["10.3389\/fpubh.2026.1871838"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1871838","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"article-number":"1871838"}}