Table 2

Application of Theory of Change in TTLT trial in Tigrai, Ethiopia, 2020

Component of ToCDescription
ImpactReducing AIDS epidemic in Tigrai
OutcomesPrimary outcomes: UNAIDS first 90, second 90 and third 90;
Secondary outcomes: QoL and stigma
InterventionsHIVST, H2H, HIVST or H2H; and
referral of HIV diagnosed people to treatment linkage, follow-up of patients on ART, and trace of LTFU patients
Rationale & pathwayExisting evidence shows effectiveness of peer educators for testing uptake, treatment linkage and retention
HIVST and H2H reduce related stigma and decrease distance to HIV care and treatment facility, enhancing HIV uptake and remain in care
AssumptionsPeer educators situated in health facilities
Peer educators able to provide home-based pinprick HIV testing and self-HIV testing services and refer to health facilities
Individuals are willing to accept self-led and peer-led finger prick HIV testing
Indicators15% increase in first, second and third UNAIDS 90 through HIVST (intervention 1) or H2H (Intervention 2)
20% increase in first, second and third UNAIDS 90 through HIVST or H2H (intervention 3)
20% increase in QoL and stigma score,
15% increase in proportion of good adherence
Improved cost-effectiveness if cost of intervention is lower than cost of standard of care
Minimal adverse effect if minor adverse (self-manageable) are reported
  • H2H, peer educators-led pinprick house-to-house HIV testing; HIVST, peer educators-led OraQuick HIV self-testing; LTFU, lost-to-follow-up; QoL, quality of life; UNAIDS, The Joint United Nations Programme on HIV/AIDS.