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Strategies to Increase HIV Testing Among MSM: A Synthesis of the Literature

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Abstract

More than 30 years into the HIV epidemic, men who have sex with men (MSM) continue to be disproportionately impacted. It is estimated that worldwide nearly half of MSM infected with HIV are unaware of their status, making HIV testing along with early linkage to care crucial to HIV prevention efforts. However, there remain significant barriers to HIV testing among MSM, due largely to complex issues of layered stigma that deter MSM from accessing traditional, clinic-based testing. We conducted a review and synthesis of the literature on strategies to increase uptake of HIV testing among MSM. We found that social network-based strategies, community-based testing, HIV self-testing, and modifications to the traditional clinic-based model can effectively reach a subset of MSM, but success was often context-specific and there are significant gaps in evidence. We provide recommendations for increasing HIV testing rates and status awareness among MSM.

Resumen

Después de más de treinta años, los hombres que tienen sexo con hombres (HSH) continúan siendo afectados desproporcionadamente por el VIH. Se estima que, mundialmente, casi la mitad de los HSH infectados con el VIH desconocen su estado, haciendo que las pruebas de VIH junto con el vínculo temprano con la atención sean cruciales para los esfuerzos de prevención del VIH. Sin embargo, sigue habiendo barreras significativas para las pruebas de detección de VIH entre HSH, debido en gran parte a problemas complejos y cumulativos de estigma que impiden que los HSH accedan a las pruebas tradicionales basadas en la clínica. Se realizó una revisión y síntesis de la literatura sobre estrategias para aumentar las pruebas del VIH entre los HSH. Encontramos que las estrategias basadas en redes sociales, las pruebas basadas en la comunidad, las auto-pruebas del VIH y modificaciones al modelo clínico tradicional pueden llegar efectivamente a un subconjunto de HSH, pero el éxito suele ser específico al contexto y existen brechas significativas en la evidencia. Proporcionamos recomendaciones para aumentar las tasas de detección del VIH y la conciencia del estado entre los HSH.

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  1. Center for AIDS Prevention Studies, University of California San Francisco, UCSF Mail Code 0886, 550 16th Street, 3rd Floor, San Francisco, CA, 94158-2549, USA

    Chadwick K. Campbell, Sheri A. Lippman & Marguerita Lightfoot

  2. Division of Communicable Disease Control & Prevention, Alameda County Public Health Department, Oakland, CA, USA

    Nicholas Moss

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Mr. Chadwick Campbell declares that he has no conflict of interest. Dr. Sheri Lippman declares that she has no conflict of interest. Dr. Nicholas Moss declares that he has no conflict of interest. Dr. Marguerita Lightfoot declares that she has no conflict of interest.

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Campbell, C.K., Lippman, S.A., Moss, N. et al. Strategies to Increase HIV Testing Among MSM: A Synthesis of the Literature. AIDS Behav 22, 2387–2412 (2018). https://doi.org/10.1007/s10461-018-2083-8

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