Mobile HIV counseling and testing removes barriers to testing among men who have sex with men in Togo
B. Clapham1, B.E. Pedersen2
1Population Services International, Communications, Lome, Togo, 2Population Services International, Washington, United States
Issues: In Togo, stigma against men who have sex with men (MSM) and individuals who are HIV positive impedes MSM from seeking medical services. A lack of health professionals trained to work with MSM and limited HIV testing facilities further restrict access, resulting in few MSM who know their HIV status.
Description: PSI/Togo’s mobile HIV Counseling and Testing (CT) services for the MSM community take advantage of activities such as a monthly film night at PSI’s center and private parties, to provide information, testing and counseling in a stigma-free environment. Trained peer educators create skits and discussions on HIV testing. Peer educators are responsible for recruiting and informing MSM about PSI’s services through text messaging or word of mouth in their tight knit network. An NGO with a longstanding relationship with MSM provides counselors who are known and trusted within the community.
Lessons learned: Mobile HIV services tested 70 MSM in four days, compared to the fixed HIV center, which tested less than 25 MSM in eight months. PSI-trained counselors played a key role in mobile testing. These counselors are trusted and respected by the MSM community and helped create a comfortable environment free of stigma.
Forty percent of men tested at mobile sites were HIV positive and received referrals to fixed HIV centers for follow-up care. Less than 10 percent returned for follow-up. This lack of continued care for HIV-positive MSM could lead to negative health outcomes, increased risk of infecting partners, and propagating the epidemic in Togo.
Next steps:The project revealed the need for research into the barriers for MSM to visit fixed centers, as well as changes needed to increase follow-up care. Due to the success of mobile testing, PSI should continue and expand services to other sites, improve the referral method, and train more counselors.