A study protocol for co-designing risk communication strategies for hepatitis C virus (HCV) testing among priority populations in Johannesburg district, Gauteng, South Africa

Background: Hepatitis C virus (HCV) infection remains a major public health challenge globally and in South Africa, particularly among key populations such as people who inject drugs (PWID), men who have sex with men (MSM), and sex workers. Despite the availability of curative direct-acting antivirals and point-of-care testing, HCV testing uptake remains suboptimal due to stigma, limited access to services, and ineffective risk communication. Evidence-informed, contextually relevant risk communication strategies are crucial to improve HCV testing uptake among priority populations. Aim: This study aims to co-design risk communication strategies to promote HCV testing among key populations in the Johannesburg District, Gauteng Province, South Africa. Methods: This study will employ a multi-phase, mixed-methods design guided by the Socio-Ecological Model and principles of Community-Based Participatory Research. Phase 1 will involve a scoping review to map evidence on barriers and facilitators to effective risk communication and HCV testing uptake. Phase 2 will use a cross-sectional design with a crowdsourcing approach to identify existing communication channels and tools. Phase 3 will apply participatory mapping with key stakeholders to co-design tailored HCV risk communication strategies. Phase 4 will use a discrete choice experiment to determine the most acceptable strategies. Data will be analysed thematically in ATLAS.ti and quantitatively in STATA. Ethics and dissemination: Ethical approval was obtained from the University of Pretoria's Faculty of Health Sciences Research Ethics Committee, and permission was granted by the Johannesburg Health District Research Committee. Findings will be disseminated through peer-reviewed publications, policy briefs, conference presentations, and community-friendly outputs.