‘No test, no disease’: Multilevel barriers to HIV testing among young men who have sex with men and transgender women in three semi-urban areas in Thailand

Multilevel Factors Impacting PrEP Engagement Among Young Gay Men and Young Transgender Women in Thailand: A Qualitative Analysis

“…36 PrEP stigma was also evidenced in adolescents' intimate relationships, with PrEP signifying mistrust; while not unique to MSM partners in Thailand, 40,41 PrEP stigma may be animated by values that privilege relational harmony over individual needs. 32 In addition to elucidating the network of factors that constrain adolescents' engagement with PrEP, our multilevel practice-based analysis suggests directions for programmatic initiatives, policy advocacy, and research to strategically position PrEP as a viable prevention tool for gay and transgender adolescents in Thailand. Table 2 illustrates select interventions that emerged from our findings and their multilevel impacts on PrEP engagement.…”

“…19 Transcripts were analyzed using deductive (applying the codebook) and inductive methods (identifying emergent codes) in an iterative process, with new codes added to the shared database. 32 Data saturation was achieved as no new codes or concepts emerged in the final transcripts. 33 In a previous analysis of these data, we focused on barriers to HIV testing among MSM and TGW adolescents.…”

Peer education interventions for HIV prevention and sexual health with young people in Mekong Region countries: a scoping review and conceptual framework

“…However, these may present particular challenges in southeast Asian contexts in which family reputation and maintaining family harmony are valued above individual liberty. 5 Similarly, open discussion of sex and sexuality may be seen as cultural taboos, more so across generations and across genders. 5 Rather than transporting and inserting PE programmes across different locales as a presumably culture-neutral intervention and expecting similar processes and outcomes to transpire, our findings suggest the importance of local stakeholder engagement and formative research to anticipate challenges, such as those due to gender dynamics, social hierarchies, and local tensions between groups of young people.…”

“… 5 Similarly, open discussion of sex and sexuality may be seen as cultural taboos, more so across generations and across genders. 5 Rather than transporting and inserting PE programmes across different locales as a presumably culture-neutral intervention and expecting similar processes and outcomes to transpire, our findings suggest the importance of local stakeholder engagement and formative research to anticipate challenges, such as those due to gender dynamics, social hierarchies, and local tensions between groups of young people. This finding is corroborated by a recent global systematic review and meta-analysis of 60 studies of PE programmes for HIV prevention among young people and adults from key populations, which identified evidence for greater PE programme effectiveness in promoting behaviour change outcomes in LMICs than in high-income countries.…”

“…Young key populations face challenges – including normative developmental concerns, legal constraints in access to services (i.e. as minors), lower levels of knowledge of HIV risks, and lesser power to mitigate those risks – that are distinct from adult key populations; 1 , 5 , 6 , 7 yet they are largely left out of the research process, programme implementation, and national strategic plans for HIV prevention and sexual health. 7 , 8…”