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. 2019 Sep 26;7(3):469-477.
doi: 10.9745/GHSP-D-19-00094. Print 2019 Sep.

Getting to the First 90: Incentivized Peer Mobilizers Promote HIV Testing Services to Men Who Have Sex With Men Using Social Media in Mumbai, India

Anjana Das  1 , Bitra George  2 , Virupax Ranebennur  3 , M R Parthasarathy  2 , G S Shreenivas  2 , Priyamvada Todankar  4 , Amit Shrivastav  4 , Ajay Kumar Reddy  2 , Christopher Akolo  3 , Michael Cassell  5 , Sandeep Mane  6 , Deepak Tripathi  6 , Jiban Baishya  7
Affiliations

Getting to the First 90: Incentivized Peer Mobilizers Promote HIV Testing Services to Men Who Have Sex With Men Using Social Media in Mumbai, India

Anjana Das et al. Glob Health Sci Pract. .

Abstract

Recent studies of Indian men who have sex with men (MSM) have shown widespread use of social media for seeking sex partners. We piloted a peer mobilization approach to explore the feasibility of engaging previously unreached MSM online to link them to HIV testing services (HTS). MSM were encouraged to seek HTS through messages posted on a popular dating website. Those who visited the designated HTS site and tested for HIV were recruited as peer mobilizers and given coupons with unique identifying codes to distribute to other men in their virtual networks. If a network member presented at the site with a coupon and tested for HIV, the peer mobilizer was given a small monetary incentive. Network members presenting at the testing site were also recruited as peer mobilizers and given coupons. In a 6-month period, 247 MSM were recruited and tested for HIV and syphilis, of whom 244 (99%) were first-time testers. Two-thirds were less than 25 years old and about half reported inconsistent or no condom use during the last 10 anal sex acts. Eight individuals (3.2%) tested positive for HIV, and 22 (8.9%) had a high titer for syphilis; all were referred to tertiary hospitals for treatment. Our approach was modestly successful in reaching and providing HTS to previously unreached MSM, but challenges included lower-than-expected recruitment, individuals not returning for posttest counseling, and loss to follow-up of individuals with HIV. The next phase of peer mobilization will aim to scale up these services through government-supported targeted interventions for this subpopulation of primarily young, unreached MSM at high risk. The challenges will be addressed by targeting more dating sites, increasing access to testing using rapid HIV tests at several community-based facilities, and offering peer navigation support for people living with HIV.

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Figures

FIGURE 1
FIGURE 1
Client Flow Abbreviations: C, coupons given to PM; CM, coupon manager; MSM, men who have sex with men; PM, peer mobilizer.
FIGURE 2
FIGURE 2
Peer Mobilization: Process and Output Indicators Abbreviations: HTS: HIV testing services; MSM, men who have sex with men; PM, peer mobilizer.
FIGURE 3
FIGURE 3
Government-Supported HIV Testing Services in Mumbai, India Abbreviations: FSW, female sex worker; MSM & TG, men who have sex with men and transgender women; PWID, persons who inject drugs; G, General HIV testing services for all; AN: Exclusive HIV testing services for antenatal women. Source of total population data: Population Census 2011. Mumbai (Greater Mumbai) City Census 2011 Data. https://www.census2011.co.in/census/city/365-mumbai.html. Accessed July 6, 2019. Source of key population data: India Health Action Trust. HIV/AIDS Situation and Response in Mumbai City and Suburban Districts: Epidemiological Appraisal Using Data Triangulation. Bangalore, India: India Health Action Trust; 2010.
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References

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