The Role of Community Health Workers Within the Continuum of Services for HIV, Viral Hepatitis, and Other STIs Amongst Men Who Have Sex with Men in Europe

Abstract

Little is known about Community Health Workers (CHWs) who work in non-clinical settings to provide sexual health support around HIV, viral hepatitis, and other sexually transmitted infections (STIs) to men who have sex with men (MSM) in Europe and neighbouring countries. This article describes for the first time, who CHWs are, and how they contribute to the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM. The first European Community Health Worker Online Survey (ECHOES) developed in the framework of the EU-funded ESTICOM project ( www.esticom.eu ), was available in 16 languages (October 2017-January 2018). Amongst the 1035 persons aged 18 and older reporting CHW activities in the previous 12 months, 28.2% were women, 30.7% were volunteers, 59.2% were men self-defining as gay/homosexual, bisexual or queer (‘peer CHWs’), and most CHWs worked/volunteered in private not-for-profit organisations (86.4%). CHWs involvement in the continuum of services for HIV, viral hepatitis and other STIs was as follows: primary prevention (88.6%), consultation and counselling (58.0%), testing provision (50.6%), linkage to care (49.8%), and treatment and support activities (51.3%). CHWs were also involved in cross-cutting activities such as developing interventions, advocacy, and engaging in research (46.3%). CHWs as a public health workforce contribute to all steps of the continuum of services for HIV, viral hepatitis, and other STIs amongst MSM in Europe. National governments should recognise and support CHWs better in order to make their activities more visible and sustainable, and increase their impact on the continuum of services.

High monkeypox vaccine acceptance among male users of smartphone-based online gay-dating apps in Europe, 30 July to 12 August 2022

“…CBOs in Europe have experience in delivering HIV, STI and viral hepatitis health services to the MSM community [ 16 ]. Public health providers should partner with CBOs in efforts to engage with the community to educate and promote uptake of MPX vaccination.…”

The role of community health workers in primary healthcare in the WHO-EU region: a scoping review

“… 2010 Qualitative study UK Lay food and Health workers Food and health initiatives People from less-affluent neighbourhoods Kenyon et al [ 59 ] 2016 Prospective, pragmatic, individually RCT. UK (Midlands) POW Maternity care Nulliparous women under 28 weeks gestation with social risk factors Kósa et al [ 74 ] 2020 Quantitative analysis Hungary Health Mediators Access to primary care services Roma minority groups López-Sánchez et al [ 47 ] 2021 Quantitative analysis Spain (Valencia) Community health workers Health literacy in the community and access to care Persons in vulnerable situations in the city of Valencia Lorente et al [ 40 ] 2021 Qualitative study 20 European countries Community health workers Sexual health support Men Who Have Sex with Men Martró et al [ 46 ] 2022 Cross-sectional study Spain Community Health Worker Hepatitis care Pakistani adults McWilliams et al [ 64 ] 2018 Qualitative study UK Lay health workers Cancer care 5 separate lay groups: (1) completed cancer treatment; (2) friends/family of cancer patients; (3) cancer hospital volu...…”

“…The interventions in the included studies targeted diverse populations: ‘hard-to-reach’, disadvantaged, underserved, deprived, or low-income areas or groups [ 39 , 47 , 49 – 53 , 55 , 60 – 63 , 65 , 66 , 69 , 70 , 75 ]; Bangladeshi and Pakistani men [ 46 , 57 , 58 ]; Roma groups [ 48 , 74 ]; (elderly) immigrants [ 41 , 43 , 45 ]; people with chronic conditions [ 73 ]; nulliparous pregnant women [ 59 ]; people living with diagnosed asthma or chronic obstructive pulmonary disease (COPD) [ 65 , 68 , 71 ]; people living with type 2 diabetes mellitus (T2DM) in socioeconomically deprived areas [ 42 ]; new-born children [ 72 ]; angina patients [ 67 ]; psychosocial vulnerable people [ 37 , 38 ]; men who have sex with men [ 40 ]; rural (farming) communities [ 44 , 76 ]; and people with experience in the criminal justice system [ 56 ].…”

“… Psychosocial support of migrants with regards to their mental health [ 43 ], psychosocial support in disadvantaged urban areas [ 63 ] or in the context of the COVID-19 pandemic [ 37 , 38 ]. Sexual and reproductive health : maternal, new-born and child health (MNCH) [ 44 , 45 ]; sexual health support for men who have sex with men [ 40 ]; and maternity care [ 59 , 62 ]. …”

Resilience outcomes and associated factors among workers in community-based HIV care centres during the Covid-19 pandemic: A multi-country analysis from the EPIC program

“…The role of CHW in HIV care and prevention is essential, particularly in countries or regions where public services were not well adapted and connected to people living with HIV (PLHIV) and to HIV key populations not reached by regular HW and health services because of discrimination [14] , [15] , [16] . The HIV response is unique and historic, with the leadership of communities and people living with HIV as a central component [17] .…”