HIV incidence and factors associated with testing positive for HIV among men who have sex with men and transgender women in Myanmar: data from community‐based HIV testing services

Coverage of HIV testing services (HTS) is generally low among men who have sex with men (MSM) and transgender women ( hijra) in Bangladesh, thus impeding the national goal of attaining the 90-90-90 target. In this context, this article delineates HTS uptake barriers among these populations. This qualitative study entailed 30 in-depth interviews, six focus groups and seven key-informant interviews with purposively selected MSM and hijra, alongside service providers. Participants cited individual and interpersonal barriers such as low risk perception and misconceptions about HIV testing, programmatic barriers such as knowledge gaps among peer service providers, as well as community and structural barriers such as the criminalization and stigmatization of male-to-male sex. Considering these contexts, it is essential for stakeholders to improve the HTS modality using multipronged approaches to address the multifaceted barriers of HTS uptake.

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Falling HIV incidence in a community clinic cohort of men who have sex with men and transgender women in Barcelona, Spain

International Journal of STD & AIDS ◽

10.1177/0956462420932424 ◽

2020 ◽

Vol 31 (9) ◽

pp. 841-848

Author(s):

Michael Meulbroek ◽

Albert Dalmau-Bueno ◽

Jorge Saz ◽

Giovanni Marazzi ◽

Fèlix Pérez ◽

...

Keyword(s):

Hiv Testing ◽

Point Of Care ◽

Transgender Women ◽

Hiv Incidence ◽

Healthcare Facilities ◽

Community Clinic ◽

Incidence Data ◽

Engagement Interventions ◽

Community Based Organization ◽

Sex With Men

In Barcelona, Spain prior to 2006, HIV testing was mostly limited to formal healthcare facilities with no incidence data reported. A community-based organization (BCN Checkpoint) was established to increase HIV testing in a peer-led community location to generate incidence data in men who have sex with men and transgender women. Three community engagement interventions were conducted between 2009 and 2017 as follows: 2009–2011 (peer-led point-of-care testing for HIV), 2012–2014 (12-monthly HIV testing with an emphasis on testing in partnerships), 2015–2017 (three-monthly HIV testing with rapid referral for antiretroviral initiation). Between 2009 and 2017 a predominantly cisgender male (99.4%) and Spanish national (62.4%) population with mean age of 34.8 years had 49,630 visits. Mean visit number increased from 1.69 in the first to 2.07 in the last three-year period. HIV incidence fell from 4.17 (95% confidence interval [CI]: 3.53–4.93) per 100 person-years in 2009–2011 to 1.57 (95% CI: 1.30–1.89) per 100 person-years in 2015–2017. This represents a 62% reduction (incidence rate ratio: 0.38, 95% CI: 0.29–0.48) between the first and third study period (p < 0.001). These early interventions may have contributed to the reduction seen in HIV incidence in this cohort.

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Uptake of oral fluid-based HIV self-testing among men who have sex with men and transgender women in Thailand

PLoS ONE ◽

10.1371/journal.pone.0256094 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256094

Author(s):

Philippe Girault ◽

Christina Misa Wong ◽

Siroat Jittjang ◽

Kangwan Fongkaew ◽

Michael M. Cassell ◽

...

Keyword(s):

Hiv Testing ◽

Urban Areas ◽

Oral Fluid ◽

Transgender Women ◽

World Health ◽

Confirmatory Test ◽

Serious Adverse Events ◽

Self Testing ◽

Hiv Testing Services ◽

Sex With Men

Background Suboptimal uptake of HIV testing remains a primary bottleneck to HIV prevention and treatment for men who have sex with men (MSM) and transgender women (TGW) in Thailand. The World Health Organization has recommended HIV self-testing (HIVST) as an additional strategic HIV service. However, HIVST has not been fully endorsed and implemented in many countries in Southeast Asia. The aim of this study was to assess the uptake of oral fluid-based HIVST in MSM and TGW populations in Thailand. Methods During 2017 and 2018, we conducted a cross-sectional study using convenience sampling to enroll 2,524 participants from three major urban areas. Participants were recruited during outreach and online activities and were offered unassisted or assisted HIVST, or referral to HIV testing services. A descriptive analysis was performed for summarizing data. Results A total of 2,502 participants (1,422 MSM and 1,082 TGW) were included in the analysis with about one-third (36.1%) of them being first-time testers. Among all participants enrolled in the study, a total of 2,486 participants (99.3%) selected HIVST versus referral to HIV testing services. Of those who selected HIVST, 2,095 (84.3%) opted for assisted HIVST while the rest opted for unassisted HIVST: 1,148 of 1,411 MSM (81.4%) and 947 of 1,075 TGW (88.1%) selected assisted HIVST. While no serious adverse events were reported during the study, we found that among 179 participants who needed a confirmatory test and were referred to HIV testing services, 108 (60.3.4%) accessed these later services. Conclusions This study demonstrated a high uptake of oral fluid-based HIVST among MSM and TGW populations in Thailand and that HIVST could be scaled up through the national epidemic control program. However, a better understanding of HIV testing-seeking behavior and innovative follow-up solutions are needed to improve and monitor linkages to services for people who undertake HIVST.

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