scholarly journals HIV testing amid COVID-19: community efforts to reach men who have sex with men in three Kenyan counties

2020 ◽  
Vol 4 ◽  
pp. 117
Author(s):  
Manas Migot Odinga ◽  
Samuel Kuria ◽  
Oliver Muindi ◽  
Peter Mwakazi ◽  
Margret Njraini ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Urban Poor ◽  
Open Letter ◽  
Community Based ◽  
Community Based Organizations ◽  
Self Testing ◽  
The Government ◽  
Sex With Men ◽  
Peer Outreach ◽  
Hiv Programs

In comparison to European and American countries, Kenya has been less impacted by the COVID-19 pandemic in terms of reported cases and mortalities. However, everyday life has been dramatically affected by highly restrictive government-imposed measures such as stay-at-home curfews, prohibitions on mobility across national and county boundaries, and strict policing, especially of the urban poor, which has culminated in violence. This open letter highlights the effects of these measures on how three community-based organizations (CBOs) deliver HIV programs and services to highly stigmatized communities of men who have sex with men living in the counties of Kisumu, Kiambu and Mombasa. In particular, emphasis is placed on how HIV testing programs, which are supported by systematic peer outreach, are being disrupted at a time when global policymakers call for expanded HIV testing and treatment targets among key populations. While government measures have greatly undermined local efforts to deliver health services to members and strengthen existing HIV testing programs, each of the three CBOs has taken innovative steps to adapt to the government restrictions and to the COVID-19 pandemic itself. Although HIV testing in clinical spaces among those who were once regular and occasional program attendees dropped off noticeably in the early months of the COVID-19 lockdown, the program eventually began to rebound as outreach approaches shifted to virtual platforms and strategies. Importantly and unexpectedly, HIV self-testing kits proved to fill a major gap in clinic-based HIV testing at a time of crisis.

scholarly journals HIV testing amid COVID-19: community efforts to reach men who have sex with men in three Kenyan counties

2020 ◽  
Vol 4 ◽  
pp. 117
Author(s):  
Manas Migot Odinga ◽  
Samuel Kuria ◽  
Oliver Muindi ◽  
Peter Mwakazi ◽  
Margret Njraini ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Urban Poor ◽  
Key Populations ◽  
Open Letter ◽  
Community Based ◽  
Community Based Organizations ◽  
Self Testing ◽  
Sex With Men ◽  
Peer Outreach ◽  
Hiv Programs

In comparison to European and American countries, Kenya has been less impacted by the COVID-19 pandemic in terms of reported cases and mortalities. However, everyday life has been dramatically affected by highly restrictive government-imposed measures such as stay-at-home curfews, prohibitions on mobility across national and county boundaries, and strict policing, especially of the urban poor, which has culminated in violence. This open letter highlights the effects of these measures on how three community-based organizations (CBOs) deliver HIV programs and services to highly stigmatized communities of men who have sex with men living in the counties of Kisumu, Kiambu and Mombasa. In particular, emphasis is placed on how HIV testing programs, which are supported by systematic peer outreach, are being disrupted at a time when global policymakers call for expanded HIV testing and treatment targets among key populations. While COVID 19 measures have greatly undermined local efforts to deliver health services to members and strengthen existing HIV testing programs, each of the three CBOs has taken innovative steps to adapt to the restrictions and to the COVID-19 pandemic itself. Although HIV testing in clinical spaces among those who were once regular and occasional program attendees dropped off noticeably in the early months of the COVID-19 lockdown, the program eventually began to rebound as outreach approaches shifted to virtual platforms and strategies. Importantly and unexpectedly, HIV self-testing kits proved to fill a major gap in clinic-based HIV testing at a time of crisis.

scholarly journals Understanding the challenges faced in community-based outreach programs aimed at men who have sex with men in urban Indonesia

Sexual Health ◽  
2020 ◽  
Vol 17 (4) ◽  
pp. 352
Author(s):  
Benjamin Hegarty ◽  
Sandeep Nanwani ◽  
Ignatius Praptoraharjo
Keyword(s):  
Focus Group ◽  
Hiv Testing ◽  
Community Involvement ◽  
Healthcare Workers ◽  
Community Outreach ◽  
Community Based ◽  
Outreach Programs ◽  
Sex With Men ◽  
Hiv Programs

Abstract Background Community-based outreach programs play an important role in the provision of HIV testing, treatment and health care for men who have sex with men (MSM) in Indonesia. However, qualitative studies of community-based HIV programs have mostly focused on clients rather than on outreach workers (OW). The experiences of MSM peer OW provide insights into how to extend and improve community involvement in HIV programs in Indonesia. Methods: This is a qualitative study based on focus group discussions, which brought together MSM OW (n = 14) and healthcare workers (n = 12). This approach facilitated documentation of the challenges associated with community-based outreach programs in Indonesia through a participatory focus group discussion between OW and healthcare workers. Results: Findings are reported in relation to challenges experienced in the context of community outreach, and solutions to the challenges faced by OW. It was found that awareness of a shared commitment to delivering HIV programs can facilitate good relationships between OW and healthcare workers. Conclusion: Future efforts should consider the role of OW within broader relationships, especially with healthcare workers, when developing community-based responses to HIV testing and treatment. Documenting the role of OW can help contribute to an understanding of ways to adapt HIV programs to reduce barriers to access both for those identified as MSM and others who are ambiguously placed in relation to the programmatic use of such categories.

Economic evaluation of HIV testing for men who have sex with men in community-based organizations – results from six European cities

AIDS Care ◽  
2016 ◽  
Vol 29 (8) ◽  
pp. 985-989 ◽  
Author(s):  
Julian Perelman ◽  
Ricardo Rosado ◽  
Omar Amri ◽  
Stéphane Morel ◽  
Daniela Rojas Castro ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Hiv Testing ◽  
Community Based ◽  
European Cities ◽  
Community Based Organizations ◽  
Sex With Men

scholarly journals Kendala Organisasi Berbasis Komunitas dalam Program Pencegahan dan Penanggulangan HIV/AIDS: Studi Kasus pada Dua LSM Peduli AIDS di Jakarta

2019 ◽  
pp. 163-174
Author(s):  
Ranti Suciati ◽  
Mujiati Mujiati ◽  
Novianti Novianti
Keyword(s):  
Social Support ◽  
Health Care ◽  
Content Analysis ◽  
Primary Health Care ◽  
Community Based ◽  
Purposive Sampling ◽  
Community Based Organizations ◽  
Primary Health ◽  
The Government ◽  
Hiv Aids

Abstrak Semakin meningkatnya jumlah kasus HIV/AIDS di Indonesia, berdampak tidak hanya pada masalah kesehatan, memacu pemerintah untuk melibatkan masyarakat sipil dalam Organisasi Berbasis Komunitas (OBK) untuk ikut berperan dalam upaya pencegahan dan penanggulangan HIV/AIDS. Pentingnya identifikasi kendala atau hambatan yang dihadapi oleh OBK memunculkan strategi atau alternatif solusi untuk mengatasi kendala, serta memberikan gambaran model intervensi yang lebih sinkron antara pemerintah dan masyarakat. Desain penelitian adalah kualitatif dengan melakukan studi kasus di dua LSM Peduli AIDS di Jakarta. Informan dipilih secara purposive sampling yaitu pengurus, anggota/petugas, dan dampingan dari dua OBK. Pengumpulan informasi dengan wawancara mendalam berdasarkan pedoman wawancara dan diolah menggunakan metode content analysis. Kendala yang dihadapi OBK yaitu alur rujukan BPJS yang mengikuti domisili sehingga memberatkan pasien, kurang optimalnya koordinasi dan kerjasama antara OBK dengan Puskesmas, belum meratanya kualitas dan kapasitas SDM anggota OBK, persoalan administratif organisasi, sumber dana yang tidak selalu kontinu, adanya perbedaan kepentingan antara OBK dengan pihak kepolisian, serta masih tingginya stigma masyarakat terhadap penderita HIV/AIDS. Solusi mengatasi kendala OBK dilakukan dengan peningkatan efektifitas pelaksanaan program pemerintah melalui OBK, antara lain dengan penerapan fleksibilitas pengelolaan dana berdasarkan kinerja OBK, peningkatan kapasitas SDM, pemantapan sistem manajerial, pemahaman alur layanan kesehatan di Puskesmas, serta social support bagi penderita HIV/AIDS. Kata kunci: organisasi berbasis komunitas, LSM, HIV/AIDS Abstract The increasing number of HIV/AIDS cases in Indonesia that impact not only on health issues, spur the Government to involve civil society in community-based organizations (OBK) to play a role in HIV/AIDS prevention program. Identification of constraints or obstacles faced by OBK do as they can generate alternative strategies or solutions to overcome these constraints, and provide a more synchronous model of intervention between the government and the community. This type of research is a case study at two AIDS Awareness NGOs in Jakarta. The informants were chosen by purposive sampling ie the board, members/officers, and assistants from the two NGOs. Information collection with by in-depth interview based on interview guideline and processed using content analysis method. Constraints faced by the OBK is the issue of referral flow pathways that follow the domicile so burdensome patients, less optimal coordination and cooperation between OBK with primary health care, uneven quality and capacity of human resources of NGO members, organizational administrative issues, sources of funds that are not always continuous, different interests between the OBK with the police department, and the stigma. Reduction of obstacles faced by OBK can be done by increasing the effectiveness of government program implementation through OBK, among others by applying flexibility of fund management based on OBK performance, human resource capacity building, managerial system strengthening, understanding of health service flow in primary health care, and social support for patient HIV/AIDS. Keywords: community-based organizations, NGOs, HIV/AIDS

scholarly journals COBA-Cohort: a prospective cohort of HIV-negative men who have sex with men, attending community-based HIV testing services in five European countries (a study protocol)

BMJ Open ◽  
2016 ◽  
Vol 6 (7) ◽  
pp. e011314 ◽  
Author(s):  
Nicolas Lorente ◽  
Laura Fernàndez-López ◽  
Ricardo Fuertes ◽  
Daniela Rojas Castro ◽  
François Pichon ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Study Protocol ◽  
Prospective Cohort ◽  
European Countries ◽  
Community Based ◽  
Hiv Testing Services ◽  
Sex With Men ◽  
Hiv Negative

An Economic Evaluation of a Community-Based Organization Led HIV Self-Testing Program Among Men Who Have Sex With Men in China

2020 ◽  
Author(s):  
Shanzi Huang ◽  
Jason Ong ◽  
Wencan Dai ◽  
Xi He ◽  
Yi Zhou ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Hiv Testing ◽  
Variable Cost ◽  
Community Based ◽  
Self Testing ◽  
Hiv Test ◽  
Community Based Organization ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Introduction: HIV self-testing (HIVST) is effective in improving the uptake of HIV testing among key populations. Complementary data on the cost-effectiveness of HIVST is critical for planning and scaling up HIVST. This study aimed to evaluate the cost-effectiveness of a community-based organization (CBO)-led HIVST model implemented in China. Method: A cost-effectiveness analysis (CEA) was conducted by comparing a CBO-led HIVST model with a CBO-led facility-based HIV rapid diagnostics testing (HIV-RDT) model. The full economic cost, including fixed and variable cost, from a health provider perspective using a micro costing approach was estimated. We determined the cost-effectiveness of these two HIV testing models over a two year time horizon (i.e. duration of the programs), and reported costs using US dollars (2020). Results: From January 2017 to December 2018, a total of 4,633 men tested in the HIVST model, and 1,780 men tested in the HIV-RDT model. The total number of new diagnosis was 155 for HIVST and 126 for the HIV-RDT model; the HIV test positivity was 3.3% (95% confidence interval (CI): 2.8-3.9) for the HIVST model and 7.1% (95% CI: 5.9-8.4) for the HIV-RDT model. The mean cost per person tested was $14.57 for HIVST and $24.74 for HIV-RDT. However, the mean cost per diagnosed was higher for HIVST ($435.52) compared with $349.44 for HIV-RDT.Conclusion: Our study confirms that compared to facility-based HIV-RDT, a community-based organization led HIVST program could have a cheaper mean cost per MSM tested for HIV in China. Better targeting of high-risk individuals would further improve the cost-effectiveness of HIVST.

scholarly journals What happens after HIV self-testing? Results from a longitudinal cohort of Chinese men who have sex with men

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiming Tang ◽  
Wenting Huang ◽  
Haidong Lu ◽  
Bolin Cao ◽  
Dan Wu ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Condom Use ◽  
Hiv Testing ◽  
Consistent Condom ◽  
Consistent Condom Use ◽  
Longitudinal Cohort ◽  
Prevention Services ◽  
Self Testing ◽  
Hiv Test ◽  
Sex With Men

Abstract Background HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. Methods We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. Results We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06). Conclusion HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.

scholarly journals ‘Break the Chains 2015’ community-based HIV prevention campaign for men who have sex with men in Switzerland: non-randomised evaluation and cost analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032459
Author(s):  
Kathrin Frey ◽  
Stéphanie Lociciro ◽  
Patricia Blank ◽  
Matthias Schwenkglenks ◽  
Françoise Dubois-Arber ◽  
...  
Keyword(s):  
At Risk ◽  
Hiv Prevention ◽  
Cost Analysis ◽  
Hiv Testing ◽  
Community Based ◽  
Prevention Campaign ◽  
Sex With Men ◽  
Hiv Acquisition ◽  
Risk Of Hiv Acquisition ◽  
Campaign Message

ObjectivesTo study the implementation, effects and costs of Break the Chains, a community-based HIV prevention campaign for men who have sex with men (MSM) in Switzerland, from March to May 2015, which aimed to reduce early HIV transmission by promoting the campaign message to adopt short-term risk reduction followed by HIV testing.DesignNon-randomised evaluation and cost analysis.SettingGay venues in 11 of 26 cantons in Switzerland and national online media campaign.ParticipantsMSM in online surveys (precampaign n=834, postcampaign n=688) or attending HIV testing centres (n=885); campaign managers (n=9); and campaign staff (n=38) or further intermediaries (n=80) in an online survey.Primary and secondary outcome measuresThe primary outcome measure was the proportion of MSM at risk of HIV acquisition or transmission who adhered to the campaign message. Secondary outcomes were postcampaign test uptake, knowledge about HIV primary infection and sense of belonging to the gay community.ResultsCampaign staff estimated that they contacted 17 145 MSM in 11 cantons. Among 688 respondents to the postcampaign survey, 311 (45.2%) were categorised as MSM at risk. Of 402/688 (58.5%) MSM who had heard about Break the Chains 2015, MSM categorised as being at risk were less likely to report adherence to the campaign message than MSM not at risk (adjusted OR 0.24; 95% CI 0.14 to 0.42). Twenty per cent of MSM with a defined risk of HIV acquisition or transmission who adopted risk reduction declared having done so because of the campaign. Costs for one MSM at risk to adhere to the campaign message were estimated at USD purchasing power parity 36–55. The number of HIV tests in the month after the campaign was twice the monthly average.ConclusionBreak the Chains increased HIV testing, implying that community-based campaigns are useful HIV prevention strategies for MSM. Additional interventions are needed to reach MSM at the highest risk of infection more effectively.

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