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Study to evaluate the feasibility of Community-based Test and Treat strategies among men who have sex with men and transgender women to increase the uptake of HIV testing and treatment services in Thailand

Tue 20 Mar 2018 Implementation Sciences
Period of the study: May 2015 – December 2020

In Thailand, KPs still face severe stigma and discrimination which often leaves them inadequate at every stage of HV continuum of prevention, care and treatment. For this reason, Key Population-Led Health Services (KPLHS) model becomes indispensable for providing such services. In collaboration with FHI 360’s LINKAGES program and funding support from United States Agency for International Development (USAID) under the US President’s Emergency Plan for AIDS Relief (PEPFAR), PREVENTION saw the ideal opportunity to complement national efforts to evaluate the feasibility of implementing Test & Treat strategy in the non-traditional settings such as drop-in centers run by community health workers.

Objectives:

  • To determine the uptake of HIV testing, enhance early diagnosis of HIV and linkage to ART and prevention among men who have sex with men (MSM) and transgender women (TGW) at very high-risk
  • To evaluate the effectiveness of enhanced community-based outreach strategies, including incentivized case finding interventions and promotion of social networking channels, to increase uptake of HIV testing and access to early care and treatment at community-based service delivery sites
  • To understand the facilitators and barriers of MSM and TGW to access HIV testing and ART at the community-based service delivery settings

Study Populations:
Starting in May 2015, this prospective observational cohort study has enrolled up to 2,705 Thai MSM and TGW from Rainbow Sky Association of Thailand (RSAT) in Bangkok and Songkhla, Service Workers in Group Foundation (SWING) in Bangkok and Chonburi, Sisters Foundation in Chonburi, Caremat and Mplus in Chiang Mai. All participants received HIV testing at baseline and were followed up to 18 – 24 months.

Initial findings include:
The study has demonstrated early diagnosis and early initiation of ART. The early diagnosis results in higher median CD4 counts of 366 cells/mm 3 than national median CD4 counts of 313 cells/mm 3 . The median (IQR) time from HIV diagnosis to ART initiation is 15 (8-22) days. More importantly, KPLHS has shown as a promising strategy to identify high-risk individuals with high seroconversion rate.

Implementation Sciences