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Approaches to Identify Unknown HIV-Positive Men Who Have Sex with Men in Nairobi, Kenya

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Abstract

Kenya has been home to one of the most severe HIV/AIDS epidemics in Sub-Saharan Africa. This persistent epidemic requires interventions tailored to affected populations, particularly men who have sex with men (MSM). Given the resource constraints of many clinics and ecological challenges of Kenya, such as the illegality of sex among MSM, interventions to address HIV must strategically engage this population. This quasi-experimental pilot study of N = 497 sought to explore differences in discovering previously unknown HIV-positive MSM in Nairobi, Kenya. The study used four clinical sites to compare a social and sexual network index testing (SSNIT) strategy compared to traditional HIV screening. Clinics using the SSNIT strategy had significantly higher incidence rates of HIV diagnoses than control clinics (IRR = 3.98, p < 0.001). This study found that building upon the social and sexual networks of MSM may be one promising strategy while discovering critical cases of HIV.

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Acknowledgements

This study would not have been possible without generous funding from amfAR, support from the University of Pittsburgh and Kenyatta National Hospital Ethical Review Board, direction from the University of Pittsburgh Center for LGBT Health Research, cooperation of the four clinical sites in Nairobi and consistent feedback from the study’s community advisory board. The authors would like to specifically thank the participants of this study for their willingness to share social and sexual contacts and willingness to participate in such a unique research study.

Funding

This pilot study was reviewed and approved by the University of Pittsburgh IRB - USA and the Kenyatta National Hospital ethical review committee - Nairobi, Kenya. This study was partially supported by amfAR, The Foundation for AIDS Research GRANT ID: 109048-56-HGMM. The National Institute on Drug Abuse (awards F31DA037647 to R.W.S.C.) and the National Center for Advancing Translational Sciences (TL1TR001858 to R.W.S.C.) of the National Institutes of Health also supported this research article.

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Authors and Affiliations

  1. Graduate School of Public Health, Center for LGBT Health Research, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Macland Njagi, Cristian J. Chandler, Robert W. S. Coulter, Ronald D. Stall & James E. Egan

  2. Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA

    Cristian J. Chandler, Robert W. S. Coulter, Ronald D. Stall & James E. Egan

  3. Division of Adolescent and Young Adult Medicine, Children’s Hospital of Pittsburgh of UPMC, 3414 Fifth Ave, Pittsburgh, PA, 15213, USA

    Robert W. S. Coulter

  4. School of Medicine, Clinical and Translational Science Institute, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA, 15261, USA

    Robert W. S. Coulter

  5. RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA, 15213, USA

    Daniel E. Siconolfi

Authors
  1. Macland Njagi
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  2. Cristian J. Chandler
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  3. Robert W. S. Coulter
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  4. Daniel E. Siconolfi
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  5. Ronald D. Stall
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  6. James E. Egan
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Corresponding author

Correspondence to James E. Egan.

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There are no conflicts of interest to report for any of this paper’s contributing authors.

Ethical Approval

This original, unpublished manuscript has not been submitted for review to any other journal, and has been read and approved by all co-authors. The funding agencies had no involvement in the study design, analysis or interpretation of data, the writing of the report, or the decision to submit for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or amfAR.

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Njagi, M., Chandler, C.J., Coulter, R.W.S. et al. Approaches to Identify Unknown HIV-Positive Men Who Have Sex with Men in Nairobi, Kenya. AIDS Behav 23, 1580–1585 (2019). https://doi.org/10.1007/s10461-018-2347-3

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  • DOI: https://doi.org/10.1007/s10461-018-2347-3

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