Behavioral interventions to reduce HIV risk behavior for MSM and transwomen in Southeast Asia: a systematic review

Abstract

This systematic review aims to gain insights from existing literature from Southeast Asian countries to improve future HIV prevention programs for men who have sex with men (MSM) and transgender women (transwomen). We conducted a systematic search in six international databases for literature published prior to 1 January 2015. We included studies describing behavioral interventions targeting MSM and/or transwomen, and conducted in at least one Southeast Asian country. Five out of 575 screened studies met the inclusion criteria and reported a significant intervention effect on at least one outcome measure, that is, condom use (with casual or commercial partner), water-based lubricant use, number of sex partners, HIV prevention knowledge, or willingness to use pre-exposure prophylaxis. Peer education/outreach was the most commonly employed type of intervention in the five included studies and was usually delivered as an element of a larger intervention package, together with condom distribution and the provision of drop-in centers. Motivational interviewing was effective, while internet-based interventions appeared to be a viable platform for intervention delivery. Nevertheless, research on behavioral interventions among MSM and transwomen in Southeast Asia is limited. Future interventions should be culturally appropriate, theoretically grounded, and rigorously evaluated. Only then can we best address the HIV epidemic among MSM and transwomen in this region.

Association between Psychological Factors and Condom Use with Regular and Nonregular Male Sexual Partners among Chinese MSM: A Quantitative Study Based on the Health Belief Model

“…The current behavior interventions or services for HIV prevention among MSM mainly focus on providing health packages, such as condoms and AIDS testing kits, videos, and digital interventions (e.g., using apps) [ 32 , 33 ]. However, if the scope of behavior interventions excluded the psychological factors, it would be difficult to achieve the intervention goals.…”

Evaluation of a training aimed at building capacity for outreaching to men who have sex with men and transgender women in Indonesia

“…Outreach to MSM and transwomen has been a primary HIV intervention component in Asian countries, including Indonesia [4][5][6]. Outreach has been perceived as a suitable approach because it brings interventions to where individuals live, work and congregate [7,8].…”

A scoping review of HIV epidemiologic, sociocultural and programmatic studies related to transgender women and men who have sex with men in Cambodia, 1999-2019

“…In terms of HIV interventions, Cambodia has benefited from significant donor support in the past decades, such as from the President's Emergency Program for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria. As mentioned above, while HIV testing uptake has strongly improved since 1999, condom use among MSM and TG has been found more difficult to increase, especially with non-commercial sexual partners [54]. This phenomenon is not unique to Cambodia, but can be seen throughout Asia [54,55] and elsewhere in the world [56].…”