Peer Mobilization and Human Immunodeficiency Virus (HIV) Partner Notification Services Among Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women in Coastal Kenya Identified a High Number of Undiagnosed HIV Infections

Abstract

Introduction HIV partner notification services (HPN), peer mobilisation with HIV self-testing and acute and early HIV infection (AEHI) screening among gay, bisexual, other men who have sex with men (GBMSM) and transgender women (TGW) were assessed for acceptability, feasibility and linkage to antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) services. Methods Between April-August 2019, peer mobilisers mobilised clients by offering HIV oral self-tests and immediate clinic referral for clients with AEHI symptoms. Mobilised participants received clinic-based rapid antibody testing and point-of-care HIV-RNA testing. Newly diagnosed participants including those derived from HIV testing services were offered immediate ART and HPN. Partners were recruited through HPN. . Results Of 772 mobilised clients, 452 (58.5%) enrolled in the study as mobilised participants. Of these, 16 (3.5%) were HIV newly diagnosed, including 2 (0.4%) with AEHI. All but two (14/16, 87.5%) initiated ART. 35 GBMSM and TGW were offered HPN and 27 (77.1%) accepted it. Provider referral identified a higher proportion of partners tested (39/64; 60.9% vs. 5/14; 35.7%) and partners with HIV (27/39; 69.2% vs. 2/5; 40.0%) than index referral. Of 44 enrolled partners, 10 (22.7%) were newly diagnosed, including 3 (6.8%) with AEHI. All 10 (100%) initiated ART. PrEP was initiated among 24.0% (103/429) mobilised participants and 28.6% (4/14) partners without HIV. Conclusions HPN, combined with a peer mobilisation-led self-testing strategy and AEHI screening for GBMSM and TGW, appears acceptable and feasible. These strategies, especially HPN provider referral, effectively identified undiagnosed HIV infections and linked individuals to ART and PrEP-services.

Self-Testing as a Hope to Reduce HIV in Transgender Women—Literature Review

“…HIV prevalence among TGW is estimated to be approximately 14.2%, which is higher compared to other vulnerable populations such as gay, bisexual, and other men who have sex with men (10.6%) [ 19 , 20 , 21 ]. Additionally, a similar trend is observed for TGW in the Middle East and North Africa, where infection rates continue to rise [ 5 , 9 ]. However, results from a study in São Paulo, Brazil, indicate an even higher prevalence of HIV among TGW compared to data from around the world [ 2 , 22 ].…”

“…They are a diverse group of people who were assigned male sex at birth but mostly identify as women, trans women, and/or transfeminine. They are estimated to be more than 48 times more likely to be infected with HIV than cis women (those whose gender identity matches that assigned at birth) of reproductive age [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Transgender women of color in particular face high rates of infection and low use of important HIV prevention tools [ 10 , 11 ].…”

Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men

“…Research with MSM continued uninterrupted for another 10 years, until complications related to the COVID pandemic later closed services. Increasingly, research was done in collaboration with LGBT groups and peer mobilisers, including an intervention trial that aimed to improve adherence to antiretroviral therapy among MSM, 116 a partner notification study that aimed to identify new HIV infections among MSM, 117 an intermittent pre-exposure prophylaxis study, 118 and the first known study to suggest that anti-MSM prejudice can be reduced among Kenyan health-care providers after sensitivity training. 119 Research with MSM was enabled through the strong support for vulnerable populations, the non-judgemental attitudes of research programme staff, and a strong community stakeholder engagement programme.…”

Reaching transgender populations in Zambia for HIV prevention and linkage to treatment using community‐based service delivery

“…Local KP CSO involvement was critical to success as it ensured a trusted member of the community was bringing services. Other studies using similar peer navigation networks to reach the community have also demonstrated success [30, 31].…”