Method

1. The effectiveness of PSI outreach activities among men who have sex with men regarding condom use and HIV testing and counseling (HTC) in Central Asia Kan, M., Imambakieva E., Koushenova L., Skakunov S., Vinogradov V., Fanarof, D. – PSI Central Asia, email: maxim.kan@psi.kz Figure 5. Percentage of MSM respondents who report having been tested for HIV and receiving results in the last 12 months in Kyrgyzstan by exposure level, 2012. USAID Dialogue on HIV and TB Project Condom Use Results BACKGROUND Figure 1. Percentage of MSM respondents in Kazakhstan who used a condom from start to finish of last sex with another man by exposure level, 2012. Projectsites: Key Populations: Figure 6. Percentage of MSM respondents who report having been tested for HIV and receiving results in the last 12 months in Tajikistan by exposure level, 2012. Figure 2. Percentage of MSM respondents in Kyrgyzstan who used a condom from start to finish of last sex with another man by exposure level, 2012. In Kazakhstan, we found that HTC utilization was higher among those that had intervention exposure through 1-3 channels, but lower among those that had exposure from 4 channels or more. In Kyrgyzstan and Tajikistan, we found that use of HTC services was higher among those with intervention exposure through a greater number of channels. It was not clear why intervention exposure to a great number of channels in Kazakhstan was associated with a lower percentage reporting use of HTC services and further exploration of this is required. There is a possibility that too many channels diluted the message in Kazakhstan. Goal: To use social networking and education to create a social norm that promotes safe sexual practices among MSM. Intervention: Interpersonal communications (through a combination of professional outreach workers, social workers and community-based volunteers), information education and communication materials, provision of access to condoms and lubricants, gender-based violence prevention, referrals to trained service providers, and community mobilization. Figure 3. Percentage of MSM respondents in Tajikistan who used a condom from start to finish of last sex with another man by exposure level, 2012. conclusions Note: a,b,c: Proportions with different superscripts are significantly different at p<0.05 or better; proportions with the same superscript are not significantly different. In Kazakhstan and Kyrgyzstan, we found higher levels of condom use among those with exposure to the intervention through multiple channels. In Tajikistan, we found higher levels of condom use among those with any exposure to intervention channels, regardless of the number, compared with those that had no intervention exposure. These results show that such HIV prevention interventions operating through multiple channels are associated with increased condom use and HTC utilization. The findings underline the importance of promoting and expanding prevention programs that promote prevention behaviors and reach at risk populations through a range of channels. Current coverage of the program among MSM is approximately 3,000 – 50% of estimated population of MSM at each site. Recommendations The key message is to scale up the volunteer component and training of outreach workers for motivational sessions that will help to promote safe sexual practices among MSM. Scale up of these programs to a high proportion of those at risk would help to reduce HIV risk behaviors. Sample size: 933 MSM Inclusion criteria: Age 18 and above; knows the size of own social network (of MSM); had at least one male sexual partner during the last 3 months; resident of the project site for a minimum 3 months. By country: Kazakhstan (Almaty city, N=330), Kyrgyzstan (Bishkek city, N=270), Tajikistan (Dushanbe city, N=333) Sampling methodology: Respondent driven sampling (RDS) Analysis: Univariate analysis of variance (UNIANOVA) was used to compare risk behaviors among populations exposed to the intervention with those who had no program exposure. Measures: 1) No exposure (no channels of exposure associated with the intervention); 2) Low exposure (1-3 channels); 3) High exposure (4 and more channels). Two main behaviors were measured: 1) Condom use (use of condom from start to finish during last anal sex with another man); 2) HIV testing and Counseling (tested for HIV and received results in the last 12 months). HIV Testing and Counseling (HTC) Method Sex workers (SWs), people living with HIV (PLHIV), people who inject drugs (PWID), migrants, prisoners, as well as This poster is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents are the sole responsibility of PSI and do not necessarily reflect the views of USAID or the United States Government.   Figure 4. Percentage of MSM respondents who report having been tested for HIV and receiving results in the last 12 months in Kazakhstan by exposure level, 2012. Men who have Sex with Men (MSM) 1120 19th Street, NW | Suite 600 Washington, DC 20036psi.org | TWITTER: @PSIHealthyLives | BLOG: psihealthylives.com 1120 19th Street, NW | Suite 600 Washington, DC 20036psi.org | TWITTER: @PSIHealthyLives | BLOG: psihealthylives.com