Effectiveness of peer-led interventions to increase HIV testing among men who have sex with men: a systematic review and meta-analysis

Shangani, S., Escudero, D., Kirwa, K., et al.

HIV testing constitutes a key step along the continuum of HIV care. Men who have sex with men (MSM) have low HIV testing rates and delayed diagnosis, especially in low-resource settings. Peer-led interventions offer a strategy to increase testing rates in this population. This systematic review and meta-analysis summarizes evidence on the effectiveness of peer-led interventions to increase the uptake of HIV testing among MSM. Using a systematic review protocol that was developed a priori, we searched PubMed, PsycINFO and CINAHL for articles reporting original results of randomized or non-randomized controlled trials (RCTs), quasi-experimental interventions, and pre- and post-intervention studies. Studies were eligible if they targeted MSM and utilized peers to increase HIV testing. We included studies published in or after 1996 to focus on HIV testing during the era of combination antiretroviral therapy. Seven studies encompassing a total of 6205 participants met eligibility criteria, including two quasi-experimental studies, four non-randomized pre- and-post intervention studies, and one cluster randomized trial. Four studies were from high-income countries, two were from Asia and only one from sub-Saharan Africa. We assigned four studies a “moderate” methodological rigor rating and three a “strong” rating. Meta-analysis of the seven studies found HIV testing rates were statistically significantly higher in the peer-led intervention groups versus control groups (pooled OR 2.00, 95% CI 1.74–2.31). Among randomized trials, HIV testing rates were significantly higher in the peer-led intervention versus control groups (pooled OR: 2.48, 95% CI 1.99–3.08). Among the non-randomized pre- and post-intervention studies, the overall pooled OR for intervention versus control groups was 1.71 (95% CI 1.42–2.06), with substantial heterogeneity among studies (I2 = 70%, p 

August 21, 2017
Year of publication
2017
Resource types
Journal and research articles
Tags
HIV testing, continuum of care, men who have sex with men (MSM), low-resource settings, peer-led interventions, key populations

Similar Resources

Global experts recognize the need to transform conventional models of healthcare to create adolescent responsive health systems.

Gay, bisexual, and other men who have sex with men (MSM) continue to have disproportionately high burdens of HIV infection in countries of low, middle, and high income in 2016.

Regular testing of individuals at higher-risk of HIV is central to current prevention strategies.

For persons at risk of HIV infection who practice receptive anal intercourse (RAI), topical rectal microbicides represent a promising option for coitally-dependent protection.

Engaging women in the dialogue on VMMC can have broad impacts on voluntary medical male circumcision (VMMC) programs, especially when women become aware that circumcision can reduce HIV risk.

Researchers from the Dutch pre-exposure prophylaxis (PrEP) demonstration study, AmPrEP, have found an unexpectedly high rate of hepatitis C virus (HCV) infection in participants tested for it at baseline.

To address barriers to care for youth living with HIV (YLHIV), the Link Up project implemented a peer-led intervention model that provided a comprehensive package of HIV and sexual and reproductive health and rights services through community-based peer support groups for YLHIV.

Male partner involvement has the potential to increase uptake of interventions to prevent mother-to-child transmission of HIV (PMTCT). Finding cultural appropriate strategies to promote male partner involvement in PMTCT programs remains an abiding public health challenge.

This cross-sectional study examined the prevalence of HIV, sexually transmitted infections (STIs), and related risks among men who have sex with men (MSM) in Dodoma Municipality, Tanzania. They used respondent-driven sampling to recruit 409 MSM aged 18 years and over.