Community health worker-led ART delivery improved scheduled antiretroviral drug refill among men who have sex with men in Lagos State, Nigeria

Ibiloye, Olujuwon; Akande, Patrick; Jwanle, Plang; Emerenini, Franklin; Omole, Temiwoluwa; Osindero, Olusola; Decroo, Tom

doi:10.1093/inthealth/ihaa021

Cited by 4 publications

(1 citation statement)

References 3 publications

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“…Although some accepted clients switched to receive HIV treatment via other service models provided by the hospitals, almost all clients remained engaged in care. While 63% retention at the CBO was moderate, a similar retention proportion (60%) was reported among MSM after 6 months of receiving the community health worker‐led ART service in Nigeria [ 32 ]. Due to the limited number of studies on the KP‐led ART maintenance service, we compared our results to retention outcomes of other community‐based ART initiation services for MSM newly started on ART: our retention results were similar to a community‐based but physician‐led ART service in Nigeria (66% at month 6) [ 33 ] but lower than the results from a KP‐led test‐and‐treat service in the Philippines (76% at month 12) [ 17 ].…”

Section: Discussionmentioning

confidence: 69%

Acceptability and retention of the key population‐led HIV treatment service for men who have sex with men and transgender women living with HIV in Thailand

et al. 2023

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Introduction In Thailand, where the HIV epidemic is concentrated among key populations (KPs), particularly men who have sex with men (MSM) and transgender women (TGW), an HIV service delivery model tailored to KPs was piloted. This study evaluated the acceptability and retention of clients who accepted and declined the KP‐led HIV treatment service. Methods A retrospective cohort study was conducted using secondary data from three community‐based organizations (CBOs) and three hospitals in Thailand. KP lay providers were trained to lead HIV treatment service in which MSM and TGW living with HIV received counselling and a 3‐month antiretroviral therapy (ART) supply at CBOs. Thai MSM and TGW who were at least 18 years, on ART for at least 6–12 months, without co‐morbidities/co‐infections, and virally suppressed were eligible and offered the service. Those who declined received ART via other service models offered by the hospitals and served as a comparison group. Results Of 220 clients screened between February 2019 and February 2020, 72% (159/220) were eligible of which 146 were MSM and 13 were TGW. Overall, 45% (72/159) accepted the KP‐led service. Of those who declined, 98% (85/87) preferred to see the physician at the hospital. After 12 months of follow‐up, among those accepted, 57% were in care at the CBO, 32% were referred back to and in care in other service models offered by the hospital, 10% were successfully transferred out to other hospital and 1% were lost to follow‐up (LTFU); among those declined, 92% were in care in any service models offered by the hospital, 5% were successfully transferred out to other hospital, 2% were LTFU and 1% died ( p ‐value<0.001). Conclusions Despite moderate acceptability and retention in care at the CBO among the clients accepting the KP‐led service, almost all clients were engaged in care overall. Multiple service models that meet the preferences and needs of KPs living with HIV should be available to optimize engagement in care.

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Section: Discussionmentioning

confidence: 69%

Acceptability and retention of the key population‐led HIV treatment service for men who have sex with men and transgender women living with HIV in Thailand

et al. 2023

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Community health workers’ commitment to HIV/AIDS control in Africa

Abdullateef,

Esanju,

Akintola

et al. 2024

Journal of Medicine, Surgery, and Public Health

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Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: A systematic review and meta-regression analysis

Stannah

Soni

Lam

et al. 2022

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Background Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. In Africa, MSM face structural barriers to HIV prevention and treatment including socio-economic disadvantages, stigma, and criminalization that increase their vulnerability to HIV acquisition and transmission and undermine progress towards ending AIDS. This systematic review explores progress towards increases in HIV testing, improving engagement in the HIV treatment cascade, and HIV incidence reductions among MSM in Africa. Methods We searched Embase, Medline, Global Health, Scopus, and Web of Science from January 1980-March 2022 for cross-sectional and longitudinal studies reporting HIV testing, knowledge of status, care, antiretroviral therapy (ART) use, viral suppression, and/or HIV incidence among MSM in Africa. We pooled surveys using Bayesian generalized linear mixed-effects models, used meta-regression to assess time trends, and compared HIV incidence estimates among MSM with those of all men. Findings Of 8,992 articles identified, we included 148 unique studies published from 2005-2022. HIV testing increased over time in Central/Western and Eastern Africa and in 2020, we estimate that 88% (95% credible interval (CrI) 57-97%) of MSM had tested in the past 12 months, but 66% (19-94%) of MSM living with HIV knew their HIV status, although this is probably underestimated given non-disclosure. Current ART use increased over time in Central/Western (ORyear=1.4, 95%CrI 1.1-2.0, N=8) and Eastern/Southern Africa (ORyear=1.4, 1.0-1.8, N=17) and in 2020 we estimate that 75% (18-98%) of MSM living with HIV in Africa were currently on ART. Nevertheless, we did not find strong evidence viral suppression increased, and in 2020 we estimate that only 62% (12-95%) of MSM living with HIV were virally suppressed. HIV incidence among MSM did not decrease over time (IRRyear=1.0, 0.7-1.3, N=38) and remained high in 2020 (5.4 per 100 person-years, 0.9-33.9) and substantially higher (27-150 times higher) than among all men. Interpretation No decreases in HIV incidence have been observed among MSM in Africa over time, despite some increases in HIV testing and ART use. Achieving the UNAIDS 95-95-95 targets for diagnosis, treatment, and viral suppression equitably for all requires renewed focus on this key population. Combination interventions for MSM are urgently required to reduce disparities in HIV incidence and tackle the social, structural, and behavioural factors that make MSM vulnerable to HIV acquisition. Funding US National Institutes of Health, UK Medical Research Council, Canadian Institutes of Health Research, Fonds de Recherche du Quebec - Sante.

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Community health worker-led ART delivery improved scheduled antiretroviral drug refill among men who have sex with men in Lagos State, Nigeria

Cited by 4 publications

References 3 publications

Acceptability and retention of the key population‐led HIV treatment service for men who have sex with men and transgender women living with HIV in Thailand

Acceptability and retention of the key population‐led HIV treatment service for men who have sex with men and transgender women living with HIV in Thailand

Community health workers’ commitment to HIV/AIDS control in Africa

Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: A systematic review and meta-regression analysis

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