Sauti Program, National Institute for Medical Research, P.O Box 1462, Mwanza, Tanzania.
Sauti Program, Jhpiego Tanzania - an affiliate of Johns Hopkins University, P.O Box 9170, Dar es Salaam, Tanzania.
BMC Public Health. 2018 Mar 20;18(1):370. doi: 10.1186/s12889-018-5303-2.
Across sub-Saharan Africa (SSA), HIV disproportionately affects men-who-have-sex-with-men (MSM) compared with other men of the same age group in the general population. Access to HIV services remains low among this group although several effective interventions have been documented. It is therefore important to identify what has worked well to increase the reach of HIV services among MSM.
We searched MEDLINE, POPLINE and the Web of Science databases to collect published articles reporting HIV interventions among MSM across sub-Saharan Africa. Covidence was used to review the articles. The review protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO) - CRD42017060808.
The search identified 2627 citations, and following removal of duplicates and inclusion and exclusion criteria, only 15 papers were eligible for inclusion in the review. The articles reported various accrual strategies, namely: respondent driven sampling, known peers identified through hotspot or baseline surveys, engagement with existing community-based organizations, and through peer educators contacting MSM in virtual sites. Some programs, however, combined some of these accrual strategies. Peer-led outreach services were indicated to reach and deliver services to more MSM. A combination of peer outreach and mobile clinics increased uptake of health information and services. Health facilities, especially MSM-friendly facilities attract access and use of services by MSM and retention into care.
There are various strategies for accrual and delivering services to MSM across SSA. However, each of these strategies have specific strengths and weaknesses necessitating combinations of interventions and integration of the specific context to inform implementation. If the best of intervention content and implementation are used to inform these services, sufficient coverage and impact of HIV prevention and treatment programs for MSM across SSA can be optimized.
在撒哈拉以南非洲（SSA），与同年龄组的普通人群中的其他男性相比，男男性行为者（MSM）感染艾滋病毒的比例过高。尽管已经有一些有效的干预措施被记录下来，但该人群获得艾滋病毒服务的机会仍然很低。因此，重要的是要确定哪些措施在扩大 MSM 获得艾滋病毒服务方面取得了良好效果。
我们搜索了 MEDLINE、POPLINE 和 Web of Science 数据库，以收集报告撒哈拉以南非洲 MSM 艾滋病毒干预措施的已发表文章。使用 Covidence 对文章进行了审查。审查方案已在国际前瞻性系统评价注册库（PROSPERO）-CRD42017060808 中进行了注册。
搜索共确定了 2627 条引文，在去除重复项和纳入排除标准后，只有 15 篇文章符合纳入审查的条件。这些文章报告了各种累积策略，即：应答者驱动抽样、通过热点或基线调查确定的已知同伴、与现有社区组织合作、以及通过在虚拟场所联系 MSM 的同伴教育者。然而，一些方案结合了这些累积策略中的一些。同行主导的外展服务被认为可以接触到更多的 MSM 并为他们提供服务。同伴外展和移动诊所的结合增加了健康信息和服务的获取。卫生设施，特别是对 MSM 友好的设施，吸引 MSM 获得和使用服务，并留住他们接受护理。
在 SSA 范围内，有各种针对 MSM 的累积和提供服务的策略。然而，每种策略都有其特定的优势和劣势，需要干预措施的组合和特定背景的整合，以提供实施指导。如果最好的干预内容和实施被用于告知这些服务，那么可以优化 SSA 范围内针对 MSM 的艾滋病毒预防和治疗方案的充分覆盖和效果。
