Abstract
Recent studies of Indian men who have sex with men (MSM) have shown widespread use of social media for seeking sex partners. We piloted a peer mobilization approach to explore the feasibility of engaging previously unreached MSM online to link them to HIV testing services (HTS). MSM were encouraged to seek HTS through messages posted on a popular dating website. Those who visited the designated HTS site and tested for HIV were recruited as peer mobilizers and given coupons with unique identifying codes to distribute to other men in their virtual networks. If a network member presented at the site with a coupon and tested for HIV, the peer mobilizer was given a small monetary incentive. Network members presenting at the testing site were also recruited as peer mobilizers and given coupons. In a 6-month period, 247 MSM were recruited and tested for HIV and syphilis, of whom 244 (99%) were first-time testers. Two-thirds were less than 25 years old and about half reported inconsistent or no condom use during the last 10 anal sex acts. Eight individuals (3.2%) tested positive for HIV, and 22 (8.9%) had a high titer for syphilis; all were referred to tertiary hospitals for treatment. Our approach was modestly successful in reaching and providing HTS to previously unreached MSM, but challenges included lower-than-expected recruitment, individuals not returning for posttest counseling, and loss to follow-up of individuals with HIV. The next phase of peer mobilization will aim to scale up these services through government-supported targeted interventions for this subpopulation of primarily young, unreached MSM at high risk. The challenges will be addressed by targeting more dating sites, increasing access to testing using rapid HIV tests at several community-based facilities, and offering peer navigation support for people living with HIV.
Highlights
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set ambitious 90-90-90 targets to accelerate the end of the HIV epidemic—that is, by 2020, 90% of people living with HIV (PLHIV) will know their HIV status, 90% of people diagnosed with HIV infection will receive sustained antiretroviral therapy (ART), and 90% of people receiving ART will have viral suppression.[1]
Project Mulakat demonstrated the feasibility of connecting with unreached virtual networks of urban Indian men who have sex with men (MSM) to promote HIV testing services (HTS) and generated practical recommendations for improving the effectiveness of the intervention
The peer mobilization approach can be integrated into targeted intervetion programs for reaching MSM not found at hot spots but active on social media
Summary
The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set ambitious 90-90-90 targets to accelerate the end of the HIV epidemic—that is, by 2020, 90% of people living with HIV (PLHIV) will know their HIV status, 90% of people diagnosed with HIV infection will receive sustained antiretroviral therapy (ART), and 90% of people receiving ART will have viral suppression.[1] Despite significantly increased access to ART among PLHIV, reduction in the rates of new HIV. Better testing approaches are needed to reach populations for which HIV risk is highest and HIV prevention, testing, and treatment coverage is lowest in order to achieve the first 90 target.[3]. The 2016– 2017 round of HIV Sentinel Surveillance conducted among a random sample of MSM registered with
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