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[Preprint]. 2024 May 30:rs.3.rs-4486078.
doi: 10.21203/rs.3.rs-4486078/v1.

Status-neutral community-based multilevel intervention to address intersectional stigma and discrimination, and increase HIV testing, PrEP, and ART uptake among YGBMSM in Ghanaian Slums: A clustered randomized control trial protocol

Gamji Rabiu Abu-Ba'are  1 , Kwasi Torpey  2 , Chris Guure  3 , LaRon E Nelson  4 , Sangchoon Jeon  4 , James McMahon  5 , Natalie M Leblanc  5 , Osman Wumpini Shamrock  1 , Edem Yaw Zigah  6 , Amos Apreku  2 , Henry Delali Dakpui  1 , George Rudolph Kofi Agbemedu  1 , Francis Boakye  7 , Prince Adu  7 , Andrew Attisoe  7 , Gideon Adjaka  8
Affiliations

Status-neutral community-based multilevel intervention to address intersectional stigma and discrimination, and increase HIV testing, PrEP, and ART uptake among YGBMSM in Ghanaian Slums: A clustered randomized control trial protocol

Gamji Rabiu Abu-Ba'are et al. Res Sq. .

Abstract

Background: While GBMSM constitute less than 2% of Ghana's population, their HIV prevalence surpasses the national average by more than eightfold, emphasizing the critical need for targeted interventions to improve detection, care linkage, and reduce community transmission. This study seeks to increase HIV testing, Pre-Exposure Prophylaxis (PrEP), and Antiretroviral Therapy (ART) uptake (HPART) among YGBMSM through the adaptation of an evidence-based intervention (LAFIYA).

Methodology: We will employ the ADAPTT-IT framework to adapt LAFIYA and evaluate its feasibility and effectiveness in addressing intersectional stigma and increasing HPART uptake among YGBMSM residing in Ghanaian slums. In aim 1, we will hold focus groups (n=5) and interviews (n=20) among YGBMSM and two FGDs among GBMSM-led organizations. At the HCF level, we will hold 6 FGDs and interviews (n=20) among nurses. In AIM 2, we will randomly assign 6 healthcare facilities (HCFs) to receive the LAFIYA (n=3) or wait-list control (n=3). Friend groups (cluster) of YGBMSM (N=240) will be assigned to receive LAFIYA (n=120) or a wait-list control (n=120). We will collect 3-, 6-, and 9-months post-intervention data among YGBMSM(n=240) and HCWs(n=300) to measure HPART adherence (primary outcomes), ISD reduction, HIV and status-neutral knowledge (secondary outcomes), and intervention acceptability, appropriateness, and feasibility (implementation outcomes).

Conclusion: The intervention group will observe increased HPART adherence, reduced ISD, and enhanced HPART knowledge and efficacy relative to the wait-list control group. The findings will inform ISD reduction and HIV status-neutral implementation strategies - and place-based interventions that address access to HIV prevention and care among YGBMSM, slum and in different settings.

Trail registration: This study was registered on clinicalTrail.gov, with identifier number NCT06312514 on 03/14/2023. https://classic.clinicaltrials.gov/ct2/show/NCT06312514.

Keywords: Antiretroviral Therapy; HIV; Healthcare; Intersectional Stigma; Pre-Exposure Prophylaxis; Testing.

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Conflict of interest statement

Additional Declarations: The authors declare no competing interests.

Figures

Figure 1
Figure 1
Application of the HSDF to LAFIYA intervention to increase HPART adherence
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References

    1. Dakpui HD, Shamrock OW, Aidoo-Frimpong G, et al. A qualitative description of HIV testing and healthcare experiences among trans women in Ghanaian urban slums BSGH-011. Published online 2024. doi:10.21203/rs.3.rs-4390892/v1 - DOI - PMC - PubMed
    1. Abu-Ba’are GR, Torpey K, Nelson L, et al. Adaptation and feasibility of Many Men Many Voices (3MV), an HIV prevention intervention to reduce intersectional stigma and increase HIVST among YSMM residing in Ghanaian slums–A clustered pre-post pilot trial protocol. Published online 2024.
    1. Abu-Ba’are GR, Shamrock OW, Apreku A, et al. Awareness and Willingness to use Condoms and Preexposure Prophylaxis among Gay, Bisexual, and Other Cisgendered Men who Have sex with men in Slum Communities in Ghana. BSGH-004. Journal of the International Association of Providers of AIDS Care (JIAPAC). 2023;22:23259582231209650. doi:10.1177/23259582231209649 - DOI - PMC - PubMed
    1. Abu-Ba’are GR, Zigah EY, Shamrock OW, et al. Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana’s slums - BSGH-005. medRxiv. Published online January 1, 2023:2023.07.29.23293357. doi:10.1101/2023.07.29.23293357 - DOI - PMC - PubMed
    1. Zigah EY, Abu-Ba’are GR, Shamrock OW, et al. “For my safety and wellbeing, I always travel to seek health care in a distant facility”–the role of place and stigma in HIV testing decisions among GBMSM – BSGH 002. Health Place. 2023;83:103076. doi:10.1016/j.healthplace.2023.103076 - DOI - PubMed

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