Strategies to improve access for MSM in low-income and middle-income countries

Rebe, Kevin; Hoosen, Nikhat; McIntyre, James

doi:10.1097/coh.0000000000000568

Cited by 16 publications

(10 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was some evidence that social media use was higher amongst those who were born outside of Johannesburg, compared to those born in the city. This may reflect lower accessibility or tolerance of offline MSM communities outside of large cities, as reported in rural and semi‐rural parts of Mpumalanga, South Africa [22].…”

Section: Discussionmentioning

confidence: 99%

“…In SSA, there are examples of surveys conducted entirely online [19,20] or that utilize a combination of online surveys and referral from community organizations [21]. However, the representativeness of MSM and TG who socialize online to wider MSM and TG populations in SSA remains unclear, and prompts concern that employing online environments for research sampling or intervention delivery may only reach a relatively affluent and educated sub‐population [22].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Online socializing among men who have sex with men and transgender people in Nairobi and Johannesburg and implications for public health‐related research and health promotion: an analysis of qualitative and respondent‐driven sampling survey data

Fearon

Bourne

Tenza

et al. 2020

J. Intern. AIDS Soc.

View full text Add to dashboard Cite

Introduction: There is little published literature about gay, bisexual and other men who have sex with men and transgender individuals (MSM and TG)'s use of social media in sub-Saharan Africa, despite repressive social and/or criminalizing contexts that limit access to physical HIV prevention. We sought to describe MSM and TG's online socializing in Nairobi and Johannesburg, identifying the characteristics of those socializing online and those not, in order to inform the development of research and health promotion in online environments. Methods: Respondent-driven sampling surveys were conducted in 2017 in Nairobi (n = 618) and Johannesburg (n = 301) with those reporting current male gender identity or male sex assigned at birth and sex with a man in the last 12 months. Online socializing patterns, sociodemographic, sexual behaviour and HIV-testing data were collected. We examined associations between social media use and sociodemographic characteristics and sexual behaviours among all, and only those HIVuninfected, using logistic regression. Analyses were RDS-II weighted. Thirty qualitative interviews were conducted with MSM and TG in each city, which examined the broader context of and motivations for social media use. Results: Most MSM and TG had used social media to socialize with MSM in the last month (60% Johannesburg, 71% Nairobi), mostly using generic platforms (e.g. Facebook), but also gay-specific (e.g. Grindr). HIV-uninfected MSM and TG reporting riskier recent sexual behaviours had raised odds of social media use in Nairobi, including receptive anal intercourse (adjusted OR = 2.15, p = 0.006), buying (aOR = 2.24, p = 0.015) and selling sex with men (aOR = 2.17, p = 0.004). Evidence for these associations was weaker in Johannesburg, though socializing online was associated with condomless anal intercourse (aOR = 3.67, p = 0.003) and active syphilis (aOR = 13.50, p = 0.016). Qualitative findings indicated that while online socializing can limit risk of harm inherent in face-to-face interactions, novel challenges were introduced, including context collapse and a fear of blackmail. Conclusions: Most MSM and TG in these cities socialize online regularly. Users reported HIV acquisition risk behaviours, yet this space is not fully utilized for sexual health promotion and research engagement. Effective, safe and acceptable means of using online channels to engage with MSM/TG that account for MSM and TG's strategies and concerns for managing online security should now be explored, as complements or alternatives to existing outreach.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Online socializing among men who have sex with men and transgender people in Nairobi and Johannesburg and implications for public health‐related research and health promotion: an analysis of qualitative and respondent‐driven sampling survey data

Fearon

Bourne

Tenza

et al. 2020

J. Intern. AIDS Soc.

View full text Add to dashboard Cite

show abstract

“…8 There is a considerable gap in evidence to guide MSM health programmes in many LMICs. 9 As a result, despite WHO recommendations, MSM are frequently excluded from syphilis testing services in Zimbabwe. 2 One way to expand MSM syphilis test uptake is self-testing.…”

Section: Introductionmentioning

confidence: 99%

Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe

et al. 2021

View full text Add to dashboard Cite

ObjectivesSelf-testing for STIs such as HIV and syphilis may empower sexual minorities and expand uptake of STI testing. While much is known about HIV self-testing (HIVST), less is known about syphilis self-testing, particularly in low-income settings. The objective of this study is to determine context-specific facilitators and barriers for self-testing and to assess the usability of syphilis self-testing in Zimbabwe among men who have sex with men (MSM).MethodsThis mixed methods study was conducted in Harare as part of a larger syphilis self-testing trial. The study included in-depth interviews (phase I) followed by usability testing and a second interview (phase II). In-depth interviews were conducted with MSM and key informants prior to syphilis self-testing. The same MSM then used the syphilis self-test, quantitatively assessed its usability and participated in a second in-depth interview. Phase I data were analysed using a thematic approach, guided by an adapted social ecological model conceptual framework. Phase II interviews were analysed using rapid assessment procedure methodology, and usability was assessed using a pre-established index, adapted from existing HIVST scales.ResultsTwenty MSM and 10 key informants were recruited for phase I in-depth interviews, and 16 of these MSM participated in phase II by completing a syphilis self-test kit. Facilitating factors for self-testing included the potential for increased privacy, convenience, autonomy, and avoidance of social and healthcare provider stigma. Barriers included the fear to test and uncertainty about linkage to care and treatment. Data from the Usability Index suggested high usability (89.6% on a 0–100 scale) among the men who received the self-test.ConclusionsMSM in Zimbabwe were willing to use syphilis self-test kits and many of the barriers and facilitators were similar to those observed for HIVST. Syphilis self-testing may increase syphilis test uptake among sexual minorities in Zimbabwe and other low-income and middle-income countries.

show abstract

“…Stigma associated with same sex relationships may also extend to healthcare facilities and professionals (9). There is also a considerable gap in evidence to guide MSM health programs in many LMICs (10). As a result, despite WHO recommendations, MSM are frequently excluded from syphilis testing services in many LMICs (2).…”

Section: Introductionmentioning

confidence: 99%

Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe

Sri-Pathmanathan

Nhamo

Mamvuto

et al. 2020

Preprint

View full text Add to dashboard Cite

Objectives: Self-testing for STIs such as HIV and syphilis may empower sexual minorities and expand uptake of STI testing. While much is known about HIV self-testing (HIVST), less is known about syphilis self-testing, particularly in low-income settings. The objective of this study is to determine context-specific facilitators and barriers for self-testing and to assess the usability of syphilis self-testing in Zimbabwe among men who have sex with men (MSM). Methods: This mixed methods study was conducted in Harare as part of a larger syphilis self-testing trial. The study included in-depth interviews (phase one) followed by usability testing and a second interview (phase two). In-depth interviews were conducted with MSM and key informants prior to syphilis self-testing. The same MSM then used the syphilis self-test, quantitatively assessed its usability and participated in a second in-depth interview. Phase one data was analysed using a thematic approach, guided by an adapted Social Ecological Model conceptual framework. Phase two interviews were analysed using Rapid Assessment Procedure qualitative methodology, and usability was assessed using a pre-established index, adapted from existing HIVST evaluation scales. Results: Twenty MSM and 10 key informants were recruited for phase one in-depth interviews and 16 of these MSM participated in phase two by completing a syphilis self-test kit. Facilitating factors for self-testing included the potential for increased privacy, convenience, autonomy and avoidance of social and healthcare provider stigma. Barriers included the fear to test and uncertainty about linkage to care and treatment. Data from the usability index suggested high usability (89.6% on a 0-100 scale) among the men who received the self-test. Conclusions: MSM in Zimbabwe were willing to use syphilis self-test kits and many of the barriers and facilitators were similar to those observed for HIVST. Syphilis self-testing may increase syphilis test uptake among sexual minorities in Zimbabwe and other low- and middle-income countries.

show abstract

Strategies to improve access for MSM in low-income and middle-income countries

Cited by 16 publications

References 43 publications

Online socializing among men who have sex with men and transgender people in Nairobi and Johannesburg and implications for public health‐related research and health promotion: an analysis of qualitative and respondent‐driven sampling survey data

Online socializing among men who have sex with men and transgender people in Nairobi and Johannesburg and implications for public health‐related research and health promotion: an analysis of qualitative and respondent‐driven sampling survey data

Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe

Syphilis self-testing to expand test uptake among men who have sex with men: a theoretically informed mixed methods study in Zimbabwe

Contact Info

Product

Resources

About