Adebajo, S., Eluwa, G., Njab, J., et al. Sexually Transmitted Infections (April 2015), doi: 10.1136/sextrans-2014-051659.
This cross-sectional study evaluated the effects of three strategies to increase the uptake of HIV counseling and testing (HCT) in Nigeria among 1,988 male most-at-risk populations (M-MARPs), such as men who have sex with men (MSM) and people who inject drugs (PWID). In the first strategy (S1), key opinion leaders referred M-MARPs to health facilities for HCT; in the second (S2), opinion leaders referred them to nearby mobile HCT teams; and in the third strategy (S3), mobile M-MARPs’ peers conducted the HCT. HCT uptake was 78 percent with S1, 84 percent with S2, and 94 percent with S3. Among M-MARPS who tested HIV-positive, 84 percent, 83 percent, and 98 percent of those reached via S1, S2 and S3, respectively, received their results. Among the first-time testers, S3 accounted for the highest proportion of HIV-positive clients (13 percent) while S2 reported the lowest proportion (3 percent). MSM and PWID reached through S1 and S2 were less likely to accept HCT compared to those reached through S3. The authors concluded that S3 (peer-led HCT) provided the highest impact on the number of M-MARPs reached, the identification of HIV-positive M-MARPs and new testers, and called for interventions to train M-MARPs peers to provide HCT.