GH12-008: Expanding test and treat for HIV prevention in MSM in Kisumu, Kenya

在撒哈拉以南非洲，男男性行为者（MSM）的艾滋病毒感染率高出2-4倍 普遍高于一般男性人口。艾滋病毒感染的比例 肯尼亚的男男性行为者占20%，但男男性行为者仍然是一个隐藏的，脆弱的，高度污名化的群体。 人口随着HPTN 052试验的成功，发现，测试，链接和保留护理（FTLR） 该模式为艾滋病毒预防带来了新的希望，但不太可能减少 除非干预措施专门针对男男性行为者， 他们在这项研究中，我们将扩大以前的工作中男男性接触者在基苏穆找到700名男子 报告在过去6个月内与另一名男子发生肛交或口交的人，并对他们进行艾滋病毒检测。 我们将把所有艾滋病毒阳性男子与总统艾滋病紧急救援计划支持的艾滋病毒护理联系起来，包括抗逆转录病毒治疗 治疗（ART），并评估基于PEPFAR指导的模型的成功，以促进 坚持抗逆转录病毒治疗，保持护理，降低风险。我们还将把所有艾滋病毒阴性的男性与 降低风险计划，包括艾滋病毒检测和持续咨询。测试结果 该计划包括以前没有测试过的男性人数，新诊断的人数，以及 艾滋病毒阳性男子需要与护理联系。对于艾滋病毒阳性的男性， 干预组成部分包括护理联系时间、分期时间、ART启动时间 保持护理，对于那些谁开始艺术，自我报告的措施，坚持和 病毒学抑制对于HIV阴性男性，干预的结果将包括 随访期间复查率和危险行为。对于两组，风险降低结果 包括减少伴侣数量和无保护肛交（UAI）， 分析了这项研究将提供必要的证据，以指导总统艾滋病紧急救援计划的规划， 在撒哈拉以南非洲扩大男男性行为者艾滋病毒的全面预防。

Men who have sex with men (MSM) in sub-Saharan Africa have 2-4 times higher HIV prevalence than the general male population. The proportion of HIV infections attributable to MSM in Kenya is 20%, yet MSM remain a hidden, vulnerable, and highly stigmatized population. With the success of the HPTN 052 trial, a find, test, link and retain in care (FTLR) model has renewed promise for HIV prevention, but is unlikely to decrease infections among MSM unless interventions are specifically adapted to and targeted for MSM in order to reach them. In this study, we will expand on previous work among MSM in Kisumu to find 700 men who report having anal or oral sex with another man in the last 6 months, and test them for HIV. We will link all HIV-positive men to PEPFAR-supported HIV care including antiretroviral therapy (ART), and evaluate the success of a model based on PEPFAR guidance to promote ART adherence, retention in care, and risk reduction. We will also link all HIV-negative men to a risk reduction program including HIV testing with ongoing counseling. Outcomes of the testing program include number of men not previously tested, number of new diagnoses, and number of HIV-positive men needing linkage to care. For the HIV-positive men, outcomes of the intervention component include time to linkage in care, time to staging, time to ART initiation, retention in care, and, for those who initiate ART, self-reported measures of adherence and virologic suppression. For the HIV-negative men, outcomes of the intervention will include retesting rates and risk behaviors while in follow-up. For both groups, risk reduction outcomes including reduction in number of partners and unprotected anal intercourse (UAI) will be analyzed. This study will provide the evidence necessary to guide PEPFAR programming for expansion of comprehensive HIV prevention among MSM in sub-Saharan Africa.