HIV prevalence, testing and treatment among men who have sex with men through engagement in virtual sexual networks in Kenya: a cross‐sectional bio‐behavioural study

Bhattacharjee, Parinita; Isac, Shajy; Musyoki, Helgar; Emmanuel, Faran; Olango, Kennedy; Kuria, Samuel; Ongaro, Martin Kyana; Walimbwa, Jeffrey; Musimbi, Janet; Mugambi, Mary; Kaosa, Shem; Kioko, Japheth; Njraini, Margret; Melon, Memory; Onyoni, Juddie; Bartilol, Kigen; Becker, Marissa; Lorway, Robert; Pickles, Michael; Moses, Stephen; Blanchard, James; Mishra, Sharmistha

doi:10.1002/jia2.25516

Cited by 26 publications

(30 citation statements)

References 32 publications

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“…Studies have shown promising practices among the different approaches targeting men/male for improved HIV testing, prevention, treatment, care and support services. [43][44][45][46][47][48][49][50][51][52][53] Health facility-level factors We found significant variation in outcomes attributable to differences at the health facility level. The variations across facilities remained statistically significant, even after controlling for individual-level and facility-level factors (Models 2 and 3).…”

Section: Individual-level Factorsmentioning

confidence: 77%

Multilevel modelling and multiple group analysis of disparities in continuity of care and viral suppression among adolescents and youths living with HIV in Nigeria

et al. 2020

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IntroductionSubstantial disparities in care outcomes exist between different subgroups of adolescents and youths living with HIV (AYLHIV). Understanding variation in individual and health facility characteristics could be key to identifying targets for interventions to reduce these disparities. We modelled variation in AYLHIV retention in care and viral suppression, and quantified the extent to which individual and facility characteristics account for observed variations.MethodsWe included 1170 young adolescents (10–14 years), 3206 older adolescents (15–19 years) and 9151 young adults (20–24 years) who were initiated on antiretroviral therapy (ART) between January 2015 and December 2017 across 124 healthcare facilities in Nigeria. For each age group, we used multilevel modelling to partition observed variation of main outcomes (retention in care and viral suppression at 12 months after ART initiation) by individual (level one) and health facility (level two) characteristics. We used multiple group analysis to compare the effects of individual and facility characteristics across age groups.ResultsFacility characteristics explained most of the observed variance in retention in care in all the age groups, with smaller contributions from individual-level characteristics (14%–22.22% vs 0%–3.84%). For viral suppression, facility characteristics accounted for a higher proportion of variance in young adolescents (15.79%), but not in older adolescents (0%) and young adults (3.45%). Males were more likely to not be retained in care (adjusted OR (aOR)=1.28; p<0.001 young adults) and less likely to achieve viral suppression (aOR=0.69; p<0.05 older adolescent). Increasing facility-level viral load testing reduced the likelihood of non-retention in care, while baseline regimen TDF/3TC/EFV or NVP increased the likelihood of viral suppression.ConclusionsDifferences in characteristics of healthcare facilities accounted for observed disparities in retention in care and, to a lesser extent, disparities in viral suppression. An optimal combination of individual and health services approaches is, therefore, necessary to reduce disparities in the health and well-being of AYLHIV.

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Section: Individual-level Factorsmentioning

confidence: 77%

Multilevel modelling and multiple group analysis of disparities in continuity of care and viral suppression among adolescents and youths living with HIV in Nigeria

et al. 2020

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“…Missing this population from a HIV program would mean denying critical HIV prevention and treatment services to a very high risk and vulnerable sub-population of MSM. In Kenya, we previously found that MSM who operate through virtual sites alone had a much higher HIV prevalence (26.7%) compared to those who seek sexual partners in physical and virtual sites (15.4%) or only physical sites (8.5%) 14 . Identifying MSM who engage in these virtual sites provides an avenue to reach them with HIV prevention and care services.…”

Section: Discussionmentioning

confidence: 97%

“…Nearly three-quarters of the MSM mainly using virtual platforms also visited physical spots to find partners, which is in concurrence with another survey conducted among MSM in these three counties. The survey showed that 14.7% of the MSM sought male sexual partners only in physical sites, 64.0% in both physical and virtual sites and 21.2% in only virtual sites 14 . These findings warrant the importance of conducting mapping of both physical and virtual platforms, as developing size estimates from a single approach may underestimate the number of MSM.…”

Section: Discussionmentioning

confidence: 99%

“…A meta-analysis of internet use among MSM concluded that approximately 35% to 45% of MSM use social media to exchange information, socialize and support each other 13 . A recent study conducted among MSM in Kenya found that 64% of the respondents used the internet and virtual platforms to seek male sexual partners 14 . These include GSN apps such as Grindr, Scruff, Adam4Adam, Gay Exchange etc., as well as social media applications such as Facebook and general communication apps like WhatsApp.…”

Section: Introductionmentioning

confidence: 99%

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Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya

et al. 2020

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Introduction: Men who have sex with men (MSM) in Kenya face a disproportionate HIV disease burden. Over the last few years, the use of virtual platforms and internet sites to seek male sexual partners has increased manyfold in Kenya. New approaches are required to map, estimate and profile MSM who operate through virtual platforms to design interventions for them. Methods: This study was conducted in three counties in Kenya: Kiambu, Kisumu and Mombasa with MSM who use virtual platforms such as geosocial networking (GSN) and social networking applications to find and connect with male sex partners. The platforms were profiled through a multi-stage approach and the number of MSM associated with these platforms were estimated. In the final stage, 435 respondents randomly selected from the virtual platforms were interviewed in a secure location after informed consent. Data analysis focused on calculating an estimate of MSM for each virtual platform in each site, adjusting for duplicate profiles and multiple registrations. Results: We identified 24 GSN apps, 18 Facebook accounts/pages and 18 WhatsApp groups across the three counties, with Facebook being the preferred platform. Kiambu had the highest number of estimated MSM at 3,635 (95%CI = 3,335 to 3,990) followed by Kisumu at 1,567 (95%CI = 1,480 to 1,665) and Mombasa at 1,469 (95%CI = 1,335 to 1,604) who used virtual platforms to find other male sexual partners. On average, each MSM had 3.7 profiles on multiple platforms, with an average of 2.1 profiles used in the past month. Conclusions: The use of conventional population size estimation approaches that focus on physical sites alone may underestimate the total number of MSM in a geography. Virtual mapping should be used in conjunction with conventional hot spot based size estimation methodologies to estimate numbers of MSM to set programmatic targets.

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“…In Kenya, key populations disproportionately contribute to the HIV epidemic and include female sex workers (FSW) and men who have sex with men (MSM), all of which experience disproportionately high prevalence of HIV at 29.3% and 18.9%, respectively (Bhattacharjee et al, 2020;Musyoki, Muraguri, Okal, & Kim, 2016;NASCOP, 2014). An estimated 18,000 PWID live in Kenya, primarily in Nairobi and coastal Kenya (NASCOP, 2019).…”

Section: Introductionmentioning

confidence: 99%

Participation in methadone programs improves antiretroviral uptake and HIV viral suppression among people who inject drugs in Kenya

Mbogo¹,

Sambai²,

Monroe‐Wise³

et al. 2022

Journal of Substance Abuse Treatment

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Background: HIV prevalence among people who inject drugs (PWID) in Kenya is estimated to be 18% compared to 4.5% in the general population. Studies from high-income countries have demonstrated that methadone use is associated with increased uptake of antiretroviral therapy (ART) and higher rates of viral suppression among PWID with HIV. However, it is unclear whether methadone use has the same effect among African PWID living with HIV. Methods: We performed a cross-sectional study to evaluate associations between methadone program participation and ART uptake and viral suppression (HIV RNA viral load <1000 copies/ml) among PWID with HIV in Kenya. Participants were recruited from needle and syringe programs and methadone clinics, interviewed on site, and samples were obtained and assayed for HIV viral loads. Univariate and multiple logistic regression were used to determine associations. Results: Among 679 participants, median age was 37 years, 48% were female, and 24% were in a methadone program. We observed higher proportions of ART use (96% vs. 87%, p = 0.001) and HIV viral suppression (78% vs. 65%, p = 0.012) among PWID on methadone compared to those not on methadone treatment. PWID who were not participating in a methadone program were 3-fold more likely to be off ART and approximately twice as likely to be viremic compared to those in methadone programs (adjusted odds ratio [aOR] = 3.35, 95% confidence interval [CI]: 1.35-8.35 and aOR = 1.90, 95% CI: 1.03-3.52, respectively). Conclusions: In this study, Kenyan PWID living with HIV participating in a methadone treatment program were more likely to be on ART and to have achieved viral suppression. Scale-up of methadone programs may have a positive impact on HIV epidemic control for this key population.

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HIV prevalence, testing and treatment among men who have sex with men through engagement in virtual sexual networks in Kenya: a cross‐sectional bio‐behavioural study

Cited by 26 publications

References 32 publications

Multilevel modelling and multiple group analysis of disparities in continuity of care and viral suppression among adolescents and youths living with HIV in Nigeria

Multilevel modelling and multiple group analysis of disparities in continuity of care and viral suppression among adolescents and youths living with HIV in Nigeria

Mapping virtual platforms to estimate the population size of men who have sex with men (MSM) who use internet to find sexual partners: implications to enhance HIV prevention among MSM in Kenya

Participation in methadone programs improves antiretroviral uptake and HIV viral suppression among people who inject drugs in Kenya

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