Feasibility of a combination HIV prevention program for men who have sex with men in Blantyre, Malawi

Andrea Wirtz, Gift Trapence, Vincent Jumbe, Eric Umar, Sosthenes Ketende, Dunker Kamba, Mark Berry, Susanne Strömdahl, Christopher Beyrer, Adamson S. Muula, Stefan Baral

Research output: Contribution to journalArticle

Abstract

Introduction: The use of combination HIV prevention interventions (CHPI) now represent the standard of care to minimize HIV acquisition risks among men who have sex with men (MSM). There has been limited evaluation of these approaches in generalized HIV epidemics and/or where MSM are stigmatized. A peer-based CHPI program to target individual, social, and structural risks for HIV was developed for MSM in Blantyre, Malawi. Methods: To test the feasibility of CHPI, adult MSM were followed prospectively from January 2012 to May 2013. Participants (N = 103) completed sociobehavioral surveys and HIV testing at each of the 3 follow-up study visits. Results: Approximately 90% of participants attended each study visit and 93.2% (n = 96) completed the final visit. Participants met with peer educators a median of 3 times (range: 1-10) in the follow-up visits 2 and 3. Condom use at last sex improved from baseline through follow-up visit 3 with main (baseline: 62.5%, follow-up 3: 77.0%; P = 0.02) and casual male partners (baseline: 70.7%, follow-up 3: 86.3%; P = 0.01). Disclosure of sexual behaviors/orientation to family increased from 25% in follow-up 1 to 55% in follow-up 3 (P , 0.01). Discussion: Participants maintained a high level of retention in the study highlighting the feasibility of leveraging community-based organizations to recruit and retain MSM in HIV prevention and treatment interventions in stigmatizing settings. Group-level changes in sexual behavior and disclosure in safe settings for MSM were noted. CHPI may represent a useful model to providing access to other HIV prevention for MSM and aiding retention in care and treatment services for MSM living with HIV in challenging environments.

Original languageEnglish (US)
Pages (from-to)155-162
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume70
Issue number2
StatePublished - Oct 1 2015

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Malawi
HIV
Sexual Behavior
Disclosure
Condoms
Feasibility Studies
Standard of Care
Organizations

Keywords

  • Cohort
  • HIV/AIDS
  • Malawi
  • Men who have sex with men
  • Prevention

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)
  • Medicine(all)

Cite this

Feasibility of a combination HIV prevention program for men who have sex with men in Blantyre, Malawi. / Wirtz, Andrea; Trapence, Gift; Jumbe, Vincent; Umar, Eric; Ketende, Sosthenes; Kamba, Dunker; Berry, Mark; Strömdahl, Susanne; Beyrer, Christopher; Muula, Adamson S.; Baral, Stefan.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 70, No. 2, 01.10.2015, p. 155-162.

Research output: Contribution to journalArticle

Wirtz, A, Trapence, G, Jumbe, V, Umar, E, Ketende, S, Kamba, D, Berry, M, Strömdahl, S, Beyrer, C, Muula, AS & Baral, S 2015, 'Feasibility of a combination HIV prevention program for men who have sex with men in Blantyre, Malawi', Journal of Acquired Immune Deficiency Syndromes, vol. 70, no. 2, pp. 155-162.
Wirtz, Andrea ; Trapence, Gift ; Jumbe, Vincent ; Umar, Eric ; Ketende, Sosthenes ; Kamba, Dunker ; Berry, Mark ; Strömdahl, Susanne ; Beyrer, Christopher ; Muula, Adamson S. ; Baral, Stefan. / Feasibility of a combination HIV prevention program for men who have sex with men in Blantyre, Malawi. In: Journal of Acquired Immune Deficiency Syndromes. 2015 ; Vol. 70, No. 2. pp. 155-162.
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abstract = "Introduction: The use of combination HIV prevention interventions (CHPI) now represent the standard of care to minimize HIV acquisition risks among men who have sex with men (MSM). There has been limited evaluation of these approaches in generalized HIV epidemics and/or where MSM are stigmatized. A peer-based CHPI program to target individual, social, and structural risks for HIV was developed for MSM in Blantyre, Malawi. Methods: To test the feasibility of CHPI, adult MSM were followed prospectively from January 2012 to May 2013. Participants (N = 103) completed sociobehavioral surveys and HIV testing at each of the 3 follow-up study visits. Results: Approximately 90{\%} of participants attended each study visit and 93.2{\%} (n = 96) completed the final visit. Participants met with peer educators a median of 3 times (range: 1-10) in the follow-up visits 2 and 3. Condom use at last sex improved from baseline through follow-up visit 3 with main (baseline: 62.5{\%}, follow-up 3: 77.0{\%}; P = 0.02) and casual male partners (baseline: 70.7{\%}, follow-up 3: 86.3{\%}; P = 0.01). Disclosure of sexual behaviors/orientation to family increased from 25{\%} in follow-up 1 to 55{\%} in follow-up 3 (P , 0.01). Discussion: Participants maintained a high level of retention in the study highlighting the feasibility of leveraging community-based organizations to recruit and retain MSM in HIV prevention and treatment interventions in stigmatizing settings. Group-level changes in sexual behavior and disclosure in safe settings for MSM were noted. CHPI may represent a useful model to providing access to other HIV prevention for MSM and aiding retention in care and treatment services for MSM living with HIV in challenging environments.",
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AU - Ketende, Sosthenes

AU - Kamba, Dunker

AU - Berry, Mark

AU - Strömdahl, Susanne

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AU - Muula, Adamson S.

AU - Baral, Stefan

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