Engaging MSM Communities in HIV Self-Testing Research and Programming in Kenya: Collaborations, Tacit Knowledge, and a Community-Based Programme Science Approach

Abstract Background: Understanding the basic principles for achieving research outcomes that are relevant to local communities is invaluable. The process allows for building of collaborative spaces and redistribution of power in knowledge production practices. This is because members of marginalized and vulnerable communities have long been critical of a research culture that has historically failed to advance meaningful collaboration and overlooks local forms of knowledge at various phases of the research processes. There has however not been a clear framework that outlines how communities should be meaningfully engaged. Rather, substantial variations in the nature of community engagements exist across research projects, thus requiring a more nuanced approach of working with communities. Methods: In this methodological paper, we describe how a community-based program science approach guided an interdisciplinary research project to inform the rollout of HIV self-testing (HIVST) among men who have sex with men (MSM) in three urban counties in Kenya. Community members and their research and programmatic partners collaborated through all phases of the research process including research design, data collection, and translation of research. Importantly, community researchers and policy makers also played an integral role in data analysis, going well beyond the conventional role of “community engagement” in global health research. Results: The study created a platform that enabled meaningful collaborations across the diverse stakeholders and allowed the MSM communities to contribute to the decisions and solutions impacting on their community. Our community-based program science approach recognizes that community researchers possess tacit knowledge, a form of expertise that formally trained researchers do not have. Conclusion: We argue that in order to fully engage with such expertise, marginalized communities must be meaningfully involved in all levels of evidence building and decision making around programs impacting their communities. We equally emphasize the importance of setting up operating norms and clear definitions of partnership roles at the initial stages of establishing collaborations. Such a move gives the community a chance to trust their capabilities and contribute more meaningfully throughout the research processes.