Community-based strategies to strengthen men’s engagement in the HIV care cascade in sub-Saharan Africa

Abstract

points• Men in sub-Saharan Africa are less likely than women to engage in HIV services across the care cascade, resulting in poorer clinical outcomes.• Health care facilities have achieved limited HIV testing and treatment coverage in men, with barriers including confidentiality concerns, distance to the facility, inconvenient hours, and perceptions that facilities provide women-centered services.Other barriers to male engagement include stigma, poverty, and feelings of compromised masculinity associated with seeking health care.• Community-based HIV interventions can overcome barriers associated with facilities and increase men's engagement in care.Social and livelihood interventions can reduce stigma and poverty.• Community-based testing interventions (particularly home and mobile) have high acceptability and reach more men than health care facility-based approaches.For men testing HIV positive, providing immediate antiretroviral therapy (ART) is associated with high retention and viral suppression.This strategy of "collapsing the cascade" provides streamlined services and reduces loss to follow-up.• Community-based interventions should be tailored to the needs of men to maximize uptake, including flexible hours, multiple follow-up visits, and convenient and private access to care.Integrating HIV testing into screening for chronic disease can reduce stigma and increase program efficiency.More research is needed on male-centered approaches to increase men's engagement in HIV services, particularly later in the cascade.Interventions targeted to men who have sex with men are urgently needed.• The current state of evidence strongly suggests that community-based test-and-treat strategies can reduce the gender disparity in HIV testing and treatment by achieving higher levels of ART coverage and viral suppression in HIV-positive men.

References 81

1. 1.
   Engaging Men in Prevention and Care for HIV/AIDS in Africa · 2012

   No notice
2. 2.

   Nsanzimana S, Remera E, Kanters S, Chan K, Forrest JI, Ford N, et al Life expectancy among HIV-positive patients in Rwanda: a retrospective observational cohort study. Lancet Glob Health. 2015;3(3):e169–77.

   Not in our library10.1016/s2214-109x(14)70364-x

3. 3.

   Geng EH, Bwana MB, Muyindike W, Glidden DV, Bangsberg DR, Neilands TB, et al Failure to initiate antiretroviral therapy, loss to follow-up and mortality among HIV-infected patients during the pre-ART period in Uganda. J Acquir Immune Defic Syndr. 2013;63(2):e64–71.

   Not in our library10.1097/qai.0b013e31828af5a6

4. 4.
   Life Expectancies of South African Adults Starting Antiretroviral Treatment: Collaborative Analysis of Cohort Studies · 2013

   No notice
5. 5.

   Tsai AC, Siedner MJ. The Missing Men: HIV Treatment Scale-Up and Life Expectancy in Sub-Saharan Africa. PLoS Med. 2015;12(11):e1001906

   Not in our library10.1371/journal.pmed.1001906

6. 6.

   Gray RH, Li X, Kigozi G, Serwadda D, Brahmbhatt H, Wabwire-Mangen F, et al Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study. Lancet. 2005;366(9492):1182–8.

   Not in our library10.1016/s0140-6736(05)67481-8

7. 7.

   WHO. Global Update on the health sector response to HIV, 2014. http://apps.who.int/iris/bitstream/10665/128494/1/9789241507585_eng.pdf?ua=1. Accessed: 10/16/2016.

   Not in our library

8. 8.

   UNAIDs. Kenya AIDS Response Progress Report, 2014. http://www.unaids.org/sites/default/files/country/documents/KEN_narrative_report_2014.pdf Accessed: 1/20/2017.

   Not in our library

9. 9.

   Wheeler T, Wolf RC, Kapesa L, Cheng Surdo A, Dallabetta G. Scaling-up HIV responses with key populations in West Africa. J Acquir Immune Defic Syndr. 2015;68 Suppl 2:S69–73.

   Not in our library10.1097/qai.0000000000000534

10. 10.

    Adebajo S, Eluwa G, Njab J, Oginni A, Ukwuije F, Ahonsi B, et al Evaluating the effect of HIV prevention strategies on uptake of HIV counselling and testing among male most-at-risk-populations in Nigeria; a cross-sectional analysis. Sex Transm Infect. 2015 12 91(8):555–60.

    Not in our library10.1136/sextrans-2014-051659

11. 11.

    Duvall S, Irani L, Compaore C, Sanon P, Bassonon D, Anato S, et al Assessment of policy and access to HIV prevention, care, and treatment services for men who have sex with men and for sex workers in Burkina Faso and Togo. J Acquir Immune Defic Syndr. 2015;68 Suppl 2:S189–97.

    Not in our library10.1097/qai.0000000000000450

12. 12.

    Tsai AC, Bangsberg DR, Weiser SD. Harnessing poverty alleviation to reduce the stigma of HIV in Sub-Saharan Africa. PLoS Med. 2013;10(11):e1001557

    Not in our library10.1371/journal.pmed.1001557

13. 13.

    Leichliter JS, Paz-Bailey G, Friedman AL, Habel MA, Vezi A, Sello M, et al 'Clinics aren't meant for men': sexual health care access and seeking behaviours among men in Gauteng province, South Africa. SAHARA J. 2011;8(2):82–8.

    Not in our library10.1080/17290376.2011.9724989

14. 14.

    Manda S, Masenyetse L, Cai B, Meyer R. Mapping HIV prevalence using population and antenatal sentinel-based HIV surveys: a multi-stage approach. Popul Health Metr. 2015;13:22

    Not in our library10.1186/s12963-015-0055-z

15. 15.

    Hogan DR, Salomon JA, Canning D, Hammitt JK, Zaslavsky AM, Barnighausen T. National HIV prevalence estimates for sub-Saharan Africa: controlling selection bias with Heckman-type selection models. Sex Transm Infect. 2012;88 Suppl 2:i17–23.

    Not in our library10.1136/sextrans-2012-050636

16. 16.

    Barnighausen T, Bor J, Wandira-Kazibwe S, Canning D. Correcting HIV prevalence estimates for survey nonparticipation using Heckman-type selection models. Epidemiology. 2011;22(1):27–35.

    Not in our library10.1097/ede.0b013e3181ffa201

17. 17.

    McGovern ME, Marra G, Radice R, Canning D, Newell ML, Barnighausen T. Adjusting HIV prevalence estimates for non-participation: an application to demographic surveillance. J Int AIDS Soc. 2015;18(1):19954.

    Not in our library10.7448/ias.18.1.19954

18. 18.

    Clark SJ, Houle B. Validation, replication, and sensitivity testing of Heckman-type selection models to adjust estimates of HIV prevalence. PLoS ONE. 2014;9(11):e112563

    Not in our library10.1371/journal.pone.0112563

19. 19.

    Bicego GT, Nkambule R, Peterson I, Reed J, Donnell D, Ginindza H, et al Recent patterns in population-based HIV prevalence in Swaziland. PLoS ONE. 2013;8(10):e77101

    Not in our library10.1371/journal.pone.0077101

20. 20.

    Eaton JW, Bacaer N, Bershteyn A, Cambiano V, Cori A, Dorrington RE, et al Assessment of epidemic projections using recent HIV survey data in South Africa: a validation analysis of ten mathematical models of HIV epidemiology in the antiretroviral therapy era. Lancet Glob Health. 2015;3(10):e598–608.

    Not in our library10.1016/s2214-109x(15)00080-7

21. 21.

    Geng EH, Bangsberg DR, Musinguzi N, Emenyonu N, Bwana MB, Yiannoutsos CT, et al Understanding reasons for and outcomes of patients lost to follow-up in antiretroviral therapy programs in Africa through a sampling-based approach. J Acquir Immune Defic Syndr. 2010;53(3):405–11.

    Not in our library10.1097/qai.0b013e3181b843f0

22. 22.
    Mass HIV Treatment and Sex Disparities in Life Expectancy: Demographic Surveillance in Rural South Africa · 2015

    No notice
23. 23.

    Leblanc NM, Andes KL. An exploration of men's knowledge, attitudes, and perceptions of HIV, HIV risk, and willingness to test for HIV in Yendi District, Northern Ghana. J Assoc Nurses AIDS Care. 2015;26(3):281–95.

    Not in our library10.1016/j.jana.2014.09.006

24. 24.

    Osoti AO, John-Stewart G, Kiarie JN, Barbra R, Kinuthia J, Krakowiak D, et al Home-based HIV testing for men preferred over clinic-based testing by pregnant women and their male partners, a nested cross-sectional study. BMC Infect Dis. 2015;15:298

    Not in our library10.1186/s12879-015-1053-2

25. 25.

    Ostermann J, Njau B, Brown DS, Muhlbacher A, Thielman N. Heterogeneous HIV testing preferences in an urban setting in Tanzania: results from a discrete choice experiment. PLoS ONE. 2014;9(3):e92100

    Not in our library10.1371/journal.pone.0092100

26. 26.

    Hensen B, Taoka S, Lewis JJ, Weiss HA, Hargreaves J. Systematic review of strategies to increase men's HIV-testing in sub-Saharan Africa. AIDS. 2014;28(14):2133–45.

    Not in our library10.1097/qad.0000000000000395

27. 27.

    Sharma M, Ying R, Tarr G, Barnabas R. Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa. Nature. 2015;528(7580):S77–85.

    Not in our library10.1038/nature16044

28. 28.
    Towards Universal Voluntary HIV Testing and Counselling: A Systematic Review and Meta-Analysis of Community-Based Approaches · 2013

    No notice
29. 29.

    Henley C, Forgwei G, Welty T, Golden M, Adimora A, Shields R, et al Scale-up and case-finding effectiveness of an HIV partner services program in Cameroon: an innovative HIV prevention intervention for developing countries. Sex Transm Dis. 2013;40(12):909–14.

    Not in our library10.1097/olq.0000000000000032

30. 30.

    Brown LB, Miller WC, Kamanga G, Nyirenda N, Mmodzi P, Pettifor A, et al HIV partner notification is effective and feasible in sub-Saharan Africa: opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr. 2011;56(5):437–42.

    Not in our library10.1097/qai.0b013e318202bf7d

31. 31.

    Cherutich P, Golden MR, Wamuti B, Richardson BA, Asbjornsdottir KH, Otieno FA, et al Assisted partner services for HIV in Kenya: a cluster randomised controlled trial. Lancet HIV. 2017 2;4(2):e74–e82.

    Not in our library10.1016/s2352-3018(16)30214-4

32. 32.

    Coates TJ, Kulich M, Celentano DD, Zelaya CE, Chariyalertsak S, Chingono A, et al Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial. Lancet Glob Health. 2014;2(5):e267–77.

    Not in our library10.1016/s2214-109x(14)70032-4

33. 33.
    Uptake of Home-Based HIV Testing, Linkage to Care, and Community Attitudes about ART in Rural KwaZulu-Natal, South Africa: Descriptive Results from the First Phase of the ANRS 12249 TasP Cluster-Randomised Trial · 2016

    No notice
34. 34.

    Petersen M. SEARCH test and treat study in Uganda and Kenya exceeds the UNAIDS 90-90-90 cascade target by achieving 81% population-level viral suppression after 2 years. [Oral] AIDS 2016 conference. Durban, South Africa. 7/20/2016.

    Not in our library

35. 35.

    Novitsky V, Bussmann H, Okui L, Logan A, Moyo S, van Widenfelt E, et al Estimated age and gender profile of individuals missed by a home-based HIV testing and counselling campaign in a Botswana community. J Int AIDS Soc. 2015;18:19918

    Not in our library10.7448/ias.18.1.19918

36. 36.

    Corbett EL, Dauya E, Matambo R, Cheung YB, Makamure B, Bassett MT, et al Uptake of workplace HIV counselling and testing: a cluster-randomised trial in Zimbabwe. PLoS Med. 2006;3(7):e238

    Not in our library10.1371/journal.pmed.0030238

37. 37.

    Sweat M, Morin S, Celentano D, Mulawa M, Singh B, Mbwambo J, et al Community-based intervention to increase HIV testing and case detection in people aged 16–32 years in Tanzania, Zimbabwe, and Thailand (NIMH Project Accept, HPTN 043): a randomised study. Lancet Infect Dis. 2011;11(7):525–32.

    Not in our library10.1016/s1473-3099(11)70060-3

38. 38.

    Chamie G, Clark TD, Kabami J, Kadede K, Ssemmondo E, Steinfeld R, et al A hybrid mobile approach for population-wide HIV testing in rural east Africa: an observational study. Lancet HIV. 2016;3(3):e111–9.

    Not in our library10.1016/s2352-3018(15)00251-9

39. 39.

    Chamie G, Kwarisiima D, Clark TD, Kabami J, Jain V, Geng E, et al Uptake of community-based HIV testing during a multi-disease health campaign in rural Uganda. PLoS ONE. 2014;9(1):e84317

    Not in our library10.1371/journal.pone.0084317

40. 40.

    Lugada E, Millar D, Haskew J, Grabowsky M, Garg N, Vestergaard M, et al Rapid implementation of an integrated large-scale HIV counseling and testing, malaria, and diarrhea prevention campaign in rural Kenya. PLoS ONE. 2010;5(8):e12435

    Not in our library10.1371/journal.pone.0012435

Cited by papers we hold 3

• Effect of door-to-door distribution of HIV self-testing kits on HIV testing and antiretroviral therapy initiation: a cluster randomised trial in Malawi · 2021
  Not checked
• HIV testing and treatment coverage achieved after 4 years across 14 urban and peri-urban communities in Zambia and South Africa: An analysis of findings from the HPTN 071 (PopART) trial. · 2020
  Not checked
• Mortality estimates by age and sex among persons living with HIV after ART initiation in Zambia using electronic medical records supplemented with tracing a sample of lost patients: A cohort study. · 2020
  Not checked

Reads

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.