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. 2022 Jun 27;12(6):e052536.
doi: 10.1136/bmjopen-2021-052536.

Preferences and access to community-based HIV testing sites among men who have sex with men (MSM) in Côte d'Ivoire

Maxime Inghels  1   2 , Arsène Kra Kouassi  2 , Serge Niangoran  3 , Anne Bekelynck  2   3 , Séverine Carilon  2 , Lazare Sika  4 , Mariatou Koné  5 , Christine Danel  3   6 , Annabel Degrées du Loû  2 , Joseph Larmarange  7 ; research team ANRS 12323 DOD-CI
Affiliations

Preferences and access to community-based HIV testing sites among men who have sex with men (MSM) in Côte d'Ivoire

Maxime Inghels et al. BMJ Open. .

Abstract

Objective: Measuring access and preferences to Men who have Sex with Men focused community-based HIV testing sites (MSM-CBTS) in Côte d'Ivoire.

Design: A respondent-driven sampling telephone survey.

Setting: National survey conducted in 2018 in Côte d'Ivoire.

Participants: 518 MSM aged over 18 years old.

Primary and secondary outcome measures: Knowledge, practices, satisfaction and preferences regarding MSM-CBTS. Factors associated with MSM-CTBS access or knowledge and with HIV testing venue preferences were examined.

Results: Only half of the respondents (47%) reported knowing of an MSM-CBTS. Of these, 79% had already attended one. Both knowing of and ever visiting an MSM-CBTS were significantly associated with a higher number of HIV tests performed in the past 12 months and having disclosed sexual orientation to one family member.In terms of preferences, 37% of respondents said they preferred undifferentiated HIV testing sites (ie, 'all patients' HIV testing sites), 34% preferred MSM-CBTS and 29% had no preference.Those who reported being sexually attracted to women, being bisexual and those who did not know an MSM non-governmental organisation were less likely to prefer MSM-CBTS. MSM who preferred undifferentiated HIV testing sites mentioned the lack of discretion and anonymity of community-based sites and the desire to avoid the gaze of others.

Conclusion: Community-based HIV testing is well suited for MSM who identify as homosexual and those close to the MSM community, while maintaining undifferentiated HIV testing is essential for others. Both types of activities need to be maintained and developed. Healthcare professionals in undifferentiated HIV testing sites need to be properly trained in the non-judgemental reception of MSM.

Keywords: HIV & AIDS; International health services; SEXUAL MEDICINE.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Respondent-driven sampling network recruitment, DOD-CI MSM, 2018 (n=518). For this figure only, the unique individual with a ‘don’t know’ response for testing preferences have been grouped with ‘no preference’. MSM, men who have sex with men.
Figure 2
Figure 2
Knowing of and having ever been in MSM-focused community-based HIV testing sites, MSM, Côte d’Ivoire, 2018 (n=510). Global p values were calculated using the Pearson χ2 test with second-order Rao-Scott corrections. Headcounts presented are RDS-weighted. MSM, men who have sex with men; NGO, non-governmental organisation; RDS, respondent-driven sampling; STI, sexually transmitted infection.
Figure 3
Figure 3
HIV testing site preferences depending on sociodemographic characteristics, identity perceptions, MSM community insertion, sexual behaviour, STI, HIV testing and sexual behaviour disclosure, RDS-weighted data, MSM, Côte d’Ivoire, 2018 (n=510). P values were calculated using the Pearson chi-squared test with second-order Rao-Scott corrections. Headcounts presented are RDS-weighted. MSM, men who have sex with men; NGO, non-governmental organisation; RDS, respondent-driven sampling; STI, sexually transmitted infection.
Figure 4
Figure 4
Reasons related to preference for MSM-dedicated HIV testing sites or undifferentiated HIV testing sites, RDS-weighted data, DOD-CI MSM, 2018 (n=368). MSM, men who have sex with men.
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