Social Influences on Engagement With HIV Testing, Treatment and Care Services Among Men Who Have Sex With Men Living in Rural Uganda

Men who have sex with men in Uganda are a heterogenous, discriminated population, experiencing high HIV burden, limited access to HIV testing, and low treatment adherence. We contribute to the lack of information about men who have sex with men in rural Uganda by using socio-ecological analyses to examine the social influences shaping their engagement with HIV services. Based on in-depth interviews with 16 men, our findings reveal the inhibitive influence of interpersonal relationships with sexual partners, peers and families, and institutional influences within health service and non-governmental organizational settings. Yet men take action to strategize and seek support to enhance engagement with HIV care in heavily criminalized and stigmatized settings. Future HIV prevention, testing, treatment, and care responses could draw on what affected individuals and communities are already doing to enhance access to HIV services and the effective support strategies of some non-governmental organizations and healthcare workers.

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High levels of mild to moderate depression among men who have sex with men and transgender women in Lima, Peru: implications for integrated depression and HIV care

10.1101/2020.01.07.20016808 ◽

2020 ◽

Author(s):

Jerome T. Galea ◽

Stephanie Marhefka ◽

Segundo R. León ◽

Guitele Rahill ◽

Elena Cyrus ◽

...

Keyword(s):

Hiv Prevention ◽

Transgender Women ◽

Hiv Care ◽

Depression Care ◽

Care Services ◽

Treatment Services ◽

Moderate Depression ◽

Prevention And Treatment ◽

Patient Health ◽

Sex With Men

ABSTRACTDepression disproportionally affects people at risk of acquiring or living with HIV and is associated with worse health outcomes; however, depression care is not routinely integrated with HIV prevention and treatment services. Selection of the best depression intervention(s) for integration depends both on the prevalence and severity of depression among potential users. To inform depression care integration in a community-based setting in Lima, Peru, we retrospectively analyzed routinely collected depression screening data from men who have sex with men and transgender women seeking HIV prevention and care services (N=185). Depression was screened for using the Patient Health Questionnaire-9. Prevalence of any depression (PHQ-9 ≥5) was 42% and was significantly associated with the last sexual partner being “casual” (p=0.01). Most (81%) depressive symptoms were mild to moderate (≥5 PHQ-9 ≤14). Integrating depression care with HIV prevention and treatment services in Peru should begin by implementing interventions targeting mild to moderate depression.

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Participation of men who have sex with men in non-governmental organizations in Belo Horizonte, 2007-2009

Revista Médica de Minas Gerais ◽

10.5935/2238-3182.20130025 ◽

2013 ◽

Vol 23 (2) ◽

Author(s):

Aníbal Fabião Murure ◽

Gustavo Machado Rocha ◽

Carla Jorge Machado ◽

Mark Drew Crosland Guimarães

Keyword(s):

Governmental Organizations ◽

Non Governmental Organizations ◽

Belo Horizonte ◽

Sex With Men

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Improving the UNAIDS 90-90-90 Treatment Targets: Solutions Suggested from a Qualitative Study of HIV Patients, Community Advocates, Health Workers and Program Managers in Jimma, Southwest Ethiopia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010378 ◽

2020 ◽

Vol 17 (1) ◽

pp. 378

Author(s):

Hailay Gesesew ◽

Paul Ward ◽

Kifle Woldemichael ◽

Lillian Mwanri

Keyword(s):

Hiv Testing ◽

Health Workers ◽

Hiv Care ◽

Religious Leaders ◽

Hiv Patients ◽

Immunological Failure ◽

Program Managers ◽

Care Services ◽

Hiv Status Disclosure ◽

Status Disclosure

Ethiopia’s performance toward the UNAIDS 90-90-90 targets is low. The present study explored interventions to improve delayed HIV care presentation (first 90), poor retention (second 90) and clinical and immunological failure (third 90). We employed a qualitative approach using in-depth interviews with 10 HIV patients, nine health workers, 11 community advocates and five HIV program managers. Ethical approvals were obtained from Australia and Ethiopia. The following were suggested solutions to improve HIV care and treatment to meet the three 90s: (i) strengthening existing programs including collaboration with religious leaders; (ii) implementing new programs such as self-HIV testing, house-to-house HIV testing, community antiretroviral therapy (ART) distribution and teach-test-treat-link strategy; (iii) decentralizing and integrating services such as ART in health post and in private clinics, and integrating HIV care services with mental illness and other non-communicable diseases; and (iv) filling gaps in legislation in issues related with HIV status disclosure and traditional healing practices. In conclusion, the study suggested important solutions for improving delayed HIV care presentation, attrition, and clinical and immunological failure. A program such as the teach-test-treat-link strategy was found to be a cross-cutting intervention to enhance the three 90s. We recommend further nationwide research before implementing the interventions.

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HIV/TB co-infection and availability of health services in relation to socio-economic status

Journal of Advanced Academic Research ◽

10.3126/jaar.v4i1.19516 ◽

2018 ◽

Vol 4 (1) ◽

pp. 27-36

Author(s):

Bhim Bahadur Subba ◽

Nirmal Rimal

Keyword(s):

Economic Status ◽

Developed Countries ◽

Cross Sectional Study ◽

Hiv Care ◽

Cross Sectional ◽

Socio Economic Status ◽

Governmental Organizations ◽

Non Governmental Organizations ◽

Sampling Procedures ◽

Cluster Of Differentiation

The human immunodeficiency virus (HIV) pandemic disproportionate affects especially less developed countries and underprivileged communities. HIV weakens immune system of infected individuals and making them more susceptible to tuberculosis (TB) infection. Both HIV and TB disease are supposed to fuel each other socially and biologically and it is further fuelled by such as poor accessibility to services, illiteracy, stigma and discrimination all these factors have pushed Nepal into more vulnerability. This article aimed to find out the availability and accessibility to the HIV/TB services in relation to socio-economic status of respondents. A cross sectional study was conducted at four HIV care and prevention centers of different non-governmental organizations (NGOs) of Nepal. In the study, 51 samples were selected using random sampling procedures who gave consent to the interview. A pre-tested semi-structured questionnaire was used to collect data. Confidentiality was highly maintained and data were analyzed. The result showed mean age of respondents’ was 36.38 years. The pre-dominant 96.1 percent of respondents were from 18-54 years of age. Respondents from all socio-economic status almost two-third indented to use government hospital than private HIV/TB services. The majority 98.0 percent of HIV infected respondents belonged to destitute to better off economic status and they were further disadvantaged by lack of knowledge and information of HIV/TB services such cluster of differentiation 4 (CD4) and viral load service.

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Increasing HIV Testing and Viral Suppression via Stigma Reduction in a Social Networking Mobile Health Intervention Among Black and Latinx Young Men and Transgender Women Who Have Sex With Men (HealthMpowerment): Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/24043 ◽

2020 ◽

Vol 9 (12) ◽

pp. e24043

Author(s):

Kathryn Elizabeth Muessig ◽

Jesse M Golinkoff ◽

Lisa B Hightow-Weidman ◽

Aimee E Rochelle ◽

Marta I Mulawa ◽

...

Keyword(s):

Hiv Testing ◽

Viral Suppression ◽

The United States ◽

Hiv Care ◽

Hiv Status ◽

Mhealth Intervention ◽

Sex With Men ◽

The University ◽

Living With Hiv ◽

Hiv Negative

Background Stigma and discrimination related to sexuality, race, ethnicity, and HIV status negatively impact HIV testing, engagement in care, and consistent viral suppression (VS) among young Black and Latinx men who have sex with men and transgender women who have sex with men (YBLMT). Few interventions address the effects of intersectional stigma among youth living with HIV and those at risk for HIV within the same virtual space. Objective Building on the success of the HealthMpowerment (HMP) mobile health (mHealth) intervention (HMP 1.0) and with the input of a youth advisory board, HMP 2.0 is an app-based intervention that promotes user-generated content and social support to reduce intersectional stigma and improve HIV-related outcomes among YBLMT. The primary objective of this study is to test whether participants randomized to HMP 2.0 report improvement in HIV prevention and care continuum outcomes compared with an information-only control arm. We will also explore whether participant engagement, as measured by paradata (data collected as users interact with an mHealth intervention, eg, time spent using the intervention), mediates stigma- and HIV care–related outcomes. Finally, we will assess whether changes in intersectional stigma and improvements in HIV care continuum outcomes vary across different types of social networks formed within the intervention study arms. Methods We will enroll 1050 YBLMT aged 15 to 29 years affected by HIV across the United States. Using an HIV-status stratified, randomized trial design, participants will be randomly assigned to 1 of the 3 app-based conditions (information-only app-based control arm, a researcher-created network arm of HMP 2.0, or a peer-referred network arm of HMP 2.0). Behavioral assessments will occur at baseline, 3, 6, 9, and 12 months. For participants living with HIV, self-collected biomarkers (viral load) are scheduled for baseline, 6, and 12 months. For HIV-negative participants, up to 3 HIV self-testing kits will be available during the study period. Results Research activities began in September 2018 and are ongoing. The University of Pennsylvania is the central institutional review board for this study (protocol #829805) with institutional reliance agreements with the University of North Carolina at Chapel Hill, Duke University, and SUNY Downstate Health Sciences University. Study recruitment began on July 20, 2020. A total of 205 participants have been enrolled as of November 20, 2020. Conclusions Among a large sample of US-based YBLMT, this study will assess whether HMP 2.0, an app-based intervention designed to ameliorate stigma and its negative sequelae, can increase routine HIV testing among HIV-negative participants and consistent VS among participants living with HIV. If efficacious and brought to scale, this intervention has the potential to significantly impact the disproportionate burden of HIV among YBLMT in the United States. Trial Registration ClinicalTrials.gov NCT03678181; https://clinicaltrials.gov/ct2/show/study/NCT03678181. International Registered Report Identifier (IRRID) DERR1-10.2196/24043

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Challenging the HIV Epidemic in Ontario Through PrEP and HIV Testing

University of Toronto Journal of Public Health ◽

10.33137/utjph.v2i2.36834 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Steven Winkelman

Keyword(s):

Hiv Testing ◽

Hiv Infections ◽

Hiv Treatment ◽

Annotated Bibliography ◽

Hiv Care ◽

Post Exposure Prophylaxis ◽

Non Profit ◽

Sex With Men ◽

Exposure Prophylaxis ◽

Priority Populations

The Ontario HIV Treatment Network (OHTN) is a non-profit network which collaborates with health clinics, AIDS service and community organizations, and policy leaders in order to improve the health and wellbeing of people living with and at risk of HIV. I joined the OHTN as a member of the Collective Impact team, with a focus on examining the barriers and facilitators to Pre-Exposure Prophylaxis (PrEP) uptake in Ontario. PrEP is a once-daily pill which is highly effective in preventing HIV infections for HIV-negative people, however usage remains relatively low in Ontario. In this role, I liaised with the Knowledge Synthesis team at OHTN to collect, analyse, and synthesize recent scientific literature on Pre and Post-exposure prophylaxis (PEP) in order to create a comprehensive annotated bibliography on PrEP research. Key findings were drawn from the research to identify potential next steps to increase PrEP use for priority populations in Ontario. Findings from the annotated bibliography were presented to OHTN staff, and have been used to assist in the development of two PrEP study proposals; 1) a cisgender and transgender women-focused PrEP education package and HIV risk screening tool, and 2) a pharmacist-led PrEP delivery pilot. I also worked with the Testing and Clinical Initiatives team at the OHTN, to aid in the implementation and evaluation of two HIV-testing projects: the GetaTest pharmacy-based HIV-testing study, and the GetaKit HIV self-testing pilot program. In this role I drafted health communication materials; analysed survey data and drafted project reports for stakeholders; and provided perspectives on the HIV-care continuum, particularly on PrEP initiation, adherence, and efficacy. My work with the OHTN was important to public health because it sought to expand access to HIV testing and prevention services for priority populations in Ontario, including men who have sex with men, and cis and trans women.

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The lived experiences of men who have sex with men when accessing HIV care services in Zimbabwe

Health SA Gesondheid ◽

10.4102/hsag.v26i0.1462 ◽

2021 ◽

Vol 26 ◽

Author(s):

Idah Moyo ◽

Margaret Macherera ◽

Azwihangwisi H. Mavhandu-Mudzusi

Keyword(s):

Family Support ◽

Clinical Training ◽

Service Providers ◽

Healthcare Services ◽

Hiv Care ◽

Healthcare Facilities ◽

Stigma And Discrimination ◽

Care Services ◽

Data Saturation ◽

Sex With Men

Background: Key populations such as men who have sex with men are disproportionately affected by human immunodeficiency virus (HIV), yet they are underserved. This vulnerable group also faces stigma and discrimination when utilising the healthcare services. However, to achieve the HIV epidemic control, it is important for them to have access to HIV care services.Aim: The aim of this study was to explore and describe the experiences of men who have sex with men (MSM) as they accessed HIV care services in healthcare settings in Bulawayo, Zimbabwe.Setting: The study setting was healthcare facilities (state and private owned) in Bulawayo, Zimbabwe, that offer HIV care services.Methods: The study used a descriptive phenomenological design targeting self-identified MSM living with HIV. Data were gathered by using in-depth individual interviews that were audio recorded. Data saturation determined sample size. Data were transcribed verbatim and later analysed thematically.Results: The study revealed that counselling given to MSM was generalised and not individualised. Some clients faced stigma and discrimination after disclosure. Peer and family support were important in the journey to access HIV care services.Conclusion: An enabling environment was not provided for MSM clients to access HIV care services in the majority of health facilities. This calls for sensitisation and competency clinical training of service providers so that the diverse needs of MSM are met. Peer and family support for MSM needs to be strengthened.

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Client perspectives on an outreach approach for HIV prevention targeting Indonesian MSM and transwomen

Health Promotion International ◽

10.1093/heapro/daz075 ◽

2019 ◽

Vol 35 (5) ◽

pp. 916-924 ◽

Cited By ~ 1

Author(s):

Adi Nugroho ◽

Vicki Erasmus ◽

Sarah E Krier ◽

Kusnindyah P Reviagana ◽

Pipiet A Laksmono ◽

...

Keyword(s):

Hiv Prevention ◽

Hiv Testing ◽

Qualitative Interviews ◽

Hiv Care ◽

Face To Face ◽

Outreach Workers ◽

The Face ◽

Positive Experiences ◽

Sex With Men ◽

Prevention Approach

Abstract This study explored clients’ perspective on an outreach approach to promote HIV testing in Indonesia targeting men who have sex with men (MSM) and transgender women (transwomen or waria). Semi-structured qualitative interviews were conducted with 32 individuals (21 MSM and 11 waria) who had received services from outreach workers (OWs) in five cities in Indonesia. Participants in this study reported positive experiences with the outreach approach and perceived OWs as their motivators in accessing HIV testing as well as HIV care and treatment. OWs provided easy-to-understand HIV information. Clients expected OWs to be well-trained and more creative in performing outreach. They perceived that the Internet and social media have helped them considerably to stay in touch with OWs. Yet, they expressed that such virtual contacts could not simply replace the face-to-face contact, especially for waria. Furthermore, clients suggested outreach to be delivered in a more appealing manner, for example through activities that may facilitate clients learning professional or life skills. They also asserted that as an HIV prevention approach, outreach needs to use more positive framing and go beyond HIV and health contents, chiefly for the youth. Future outreach programmes should facilitate OWs in providing tailored services based on the level and type of support that the clients need, and in applying varied proportion and levels of sophistication in the use of online and virtual platforms for outreach.

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