Community HIV Screening Among MSM in Three Indonesian Cities

Abstract

Background: Indonesia lags behind its peers with regard to ART coverage of PLHIV. Insufficient HIV testing among MSM and other key affected populations remains a barrier to increasing ART coverage. Objective: This report presents the results of the first government-endorsed implementation research study of a community screening approach to increasing the rate of HIV testing among MSM in three cities. Methods: All new MSM outreach contacts meeting eligibility criteria during March-June 2017 were included in the study. HIV testing at a government health facility, which is required to qualify for government-supported ART, was advised for all new contacts. Men refusing formal testing were offered an HIV screening test in a community setting using a saliva-based rapid test and advised to get a confirmatory test at a health facility. All outreach contacts and testing activities were recorded on individual client records. Results: Of 1,149 eligible MSM, 27% were willing to be referred to receive HIV testing at a health facility, among which 83% were confirmed to have been tested. Of the 838 study subjects refusing health facility testing, 38% accepted community screening. The screening positivity rate was 14.8%. Only 38% of men with reactive screening tests received a confirmatory test at a health facility, along with 8% of those with non-reactive tests. Conclusion: While community screening resulted in more MSM knowing their HIV status, reluctance to avail government health facility-based services, or indeed to be tested at all, must be addressed if community screening is to accelerate progress in getting HIV-positive MSM onto treatment.

Key populations and power: people-centred social innovation in Asian HIV services

“…30 Similarly in Indonesia, community screening sites provided a complementary entry point to HIV services among MSM reluctant to seek HIV testing at government-run health facilities. 31 In summary, engaging key populations in HIV interventions is able to bring services to the community and its members who are otherwise marginalized by discriminatory laws and norms. With accessible HIV services and resources at the community, individuals can exert increased control over their health.…”

The short-term effects of COVID-19 on HIV and AIDS control efforts among female sex workers in Indonesia

“…To the extent that socially marginalized HIV “key populations” are reluctant to avail of government testing and treatment services as was also observed in a recent study among MSM is three Indonesian cities [ 29 ], the impact of community testing will be muted. The study findings serve as a reminder that COVID-19 responses do not negate the need to address stigma and discrimination toward socially marginalized sub-populations [ 30 ]. The preliminary community testing findings support recent calls for expedited HIV differentiated service delivery [ 31 ], expanded use of alternative service delivery platforms such as “telemedicine” [ 32 ], and expanded community-based action both during and beyond the COVID-19 pandemic [ 33 ].…”

Counseling Supporting HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men: Systematic Review and Meta-Analysis

“…Other programs did not provide active counseling to users. Users could report their results via a web-based platform and obtain optional posttest counseling [ 27 ]. This mode of counseling support was categorized as passive counseling [ 24 , 25 ].…”

“…In addition, the number of essential components involved in counseling support varied significantly. Some studies only involved a single essential component (eg, providing additional HIV care for HIVST users who received reactive results), whereas others provided more comprehensive support (eg, assessing the risks and window periods, delivering preventive information and materials, and providing additional HIV care for HIVST users who received reactive results) [ 26 , 27 ].…”