Project Lead(s): Luis Menacho
In Peru, HIV is concentrated among men who have sex with men (MSM), with a prevalence of 12.4% compared to 0.5% in the general population.
It is estimated that fewer than 50% of MSM have been tested for HIV and stigma remains a barrier to the uptake of clinic-based prevention services.
The project aimed to promote HIV testing among MSM by encouraging them to attend a healthcare centre using a cell phone-based tailored intervention.
Qualitative data was collected on interests of the target population on topics of sexual and general health, and a set of text messages to be used during the intervention was developed, with the objective of overcoming the main barriers to HIV testing.
Training of health tutors and guidelines for interacting with participants were developed, focused on time and frequency of interaction, topics and order of delivery, logistic issues, frequently asked questions, key points for setting an appointment, designing a stigma-free approach, potential problems and communication strategy.
The Internet was used to recruit the target population (MSM) by employing banners on the most visited Peruvian gay websites, as well as on Facebook.
After enrollment, participants were randomized to an intervention or a control arm. During three months of follow-up, the intervention arm received three weekly text messages on their cell phones related to HIV prevention (testing, risks, fear, etc.) and the control arm received no messages. In order to create rapport between the health counsellors and the participants during the initial four weeks, messages related to general health (exercise, nutrition, etc.) were sent. Subsequently, the messages related to the intervention were sent to the participants. The three weekly messages sent by the counsellors provided participants with the opportunity to respond and request more information.
The cell phone-based intervention was successful in linking MSM with a health centre to receive HIV prevention services, by overcoming the barriers of stigma and discrimination.
The study team had estimated about 34 men in the intervention group, versus 11 controls, would be tested for HIV. However, results showed that 75 participants in the intervention arm received an HIV test at one of the health centres, versus 25 in the control arm.
This outcome was measured by determining how many participants in the intervention arm set up an appointment using their cell phones and subsequently attended the appointment.
The project also made a number of individuals aware of their HIV status and provided them with the opportunity to receive HIV care.
Overall, 29% (23 out of 80) of the subjects tested positive for HIV and 75% of those who tested positive were linked to HIV care at the same institution where they were diagnosed.
The project team was successful in building a partnership with Via Libre, which is an NGO working on HIV prevention, research, services for HIV care that provides antiretroviral therapy for free.
The team intends to publish the results of the study and scale up the intervention.