Community-Based Interventions as Opportunities to Increase HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men - Lessons From Ghana, West Africa.

Gamji M'Rabiu Abubakari,Francis Boakye,Zhao Ni,LaRon E Nelson,Kwasi Torpey,Yaw Amanfoh,Donaldson F Conserve,DeAnne Turner,Amma Otchere,Debbie Dada

doi:10.3389/fpubh.2021.660256

Abstract

MSM in Ghana encounter challenges in accessing HIV services and may experience barriers to HIV self-testing due to multiple forms of stigma present in health care settings. We worked with community-based organization partners to implement three interventions that successfully engaged and retained MSM which provides an opportunity for linkage to self-testing and medical care. These interventions were (1) Many Men Many Voices (3MV) a locally-led culturally grounded group-level HIV prevention program, (2) Auntie's Corner: a mobile-app based connecting MSM to health monitoring by a registered nurse and (3) HIV Education, Empathy, & Empowerment (HIVE3): a mobile-app based peer support intervention for MSM living with HIV. The 3MV intervention may be effective in improving HIV self-testing due to its effectiveness in engaging MSM, increasing HIV testing, and improving MSM understanding of the need for HIV testing. The utilization of apps like Auntie's Corner could positively impact HIV self-testing among MSM because it increases contact with nurses and reporting of symptoms. In HIVE3, participants expressed appreciation of the security and privacy that protects their identities as MSM and the peer mentors' abilities to make referrals to the nurses in Auntie's Corners. The confidentiality component has proven key among MSM and connecting MSM to self-testing through apps to report their process and receive care could increase utilization. Together, we show the efficacy of using the community-engaged process in reaching and engaging highly stigmatized populations like Ghana and sub-Saharan Africa, and its potential in increasing HIV self-testing and linkage to HIV care.

Highlights

Men who have sex with men (MSM) have an ∼26 times greater risk of contracting HIV than the general population [1]
Given the stigma associated with seeking in-person care as an men who have sex with men (MSM) in Ghana or other sub-Saharan African countries [7], our findings suggest that mobile platforms and digital technology could be useful in ensuring a safe and private healthcare-seeking experience [7, 12]
As HIVST continues to spread across the globe and contribute immensely to increasing HIV testing acceptability among key populations, MSM within Sub-Saharan Africa (SSA) countries who face extreme stigmas at various levels such as family, friends, and even from health care workers will immensely benefit from this new intervention

Summary

INTRODUCTION

Men who have sex with men (MSM) have an ∼26 times greater risk of contracting HIV than the general population [1]. We have conducted three community-based HIV interventions with MSM in Ghana (Table 1) that can positively inform the implementation of HIVST programs in West Africa These three studies include a modified version of the Many Men Many Voices – 3MV (Nyansapo) intervention, Auntie’s Corner, and HIV Education, Empathy, & Empowerment (HIVE3). As a component of our dual intervention, Aunties Corner aimed to test the feasibility and acceptability of a smartphone-based mobile application (app) for use by HIV-positive MSM to report HIV symptoms and quality of life to registered nurses. HIV self-testing studies could connect MSM with providers virtually for support and collection of self-reported data to monitor MSM’s real-time HIV testing results and behaviors as MSM are comfortable in using mobile apps for sharing personal, and sensitive, health information is feasible, and acceptable. The full results of Aunties Corner and HIVE3 studies (which were approved by Institutional Review Boards of University of Rochester in the United States, and Kwame Nkrumah University of Science and Technology in Ghana) will be published elsewhere

DISCUSSION

A Conducive and Private Environment Will Facilitate Learning and HIVST Practice

CONCLUSION

Findings

DATA AVAILABILITY STATEMENT

ETHICS STATEMENT