Poe Poe Aung1, Claire Ryan2, Ashish Bajracharya3, Naanki Pasricha2, Zaw Win Thein1, Paul A Agius4, Than Tun Sein5, Lisa Willenberg2, Ei Mon Soe6, Ne Tun Zaw7, Waimar Tun8, Eileen Yam8, Stanley Luchters9. 1. Burnet Institute, Yangon, Myanmar; Institute for Global Health, Yangon, Myanmar; University of Maryland, Baltimore, Maryland. 2. Burnet Institute, Melbourne, Victoria, Australia. 3. Population Council, Phnom Penh, Cambodia. Electronic address: abajracharya@popcouncil.org. 4. Burnet Institute, Melbourne, Victoria, Australia; Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia. 5. Burnet Institute, Yangon, Myanmar. 6. International HIV/AIDS Alliance, Yangon, Myanmar; Volunteer Service Overseas, Yangon, Myanmar. 7. Marie Stopes International, Yangon, Myanmar. 8. Population Council, Washington, DC. 9. Burnet Institute, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; International Centre for Reproductive Health, Ghent University, Ghent, Belgium.
Abstract
PURPOSE: Young men who have sex with men (YMSM) in Myanmar are disproportionately affected by HIV, with prevalence five times that of the general population. The Link Up project implemented an intervention using peer education and outreach providing education and counseling on health seeking around sexually transmitted infections and reproductive health, combined with focused clinic capacity building to improve the sexual and reproductive health of YMSM. This study aimed to evaluate the effectiveness and acceptability of the intervention. METHODS: Using a mixed-methods approach, and employing a quasi-experimental design, we conducted two quantitative repeat cross-sectional surveys in purposively selected control (no intervention) and intervention townships, before and after implementation of the Link Up intervention. Respondent-driven sampling was used to recruit YMSM aged 15-24 years, and study participants were administered a structured questionnaire assessing intervention exposure, health service access, knowledge of HIV, and sexual risk behavior. Focus group discussions were held to elicit perspectives on the use and acceptability of the health services and peer outreach. RESULTS: At baseline, 314 YMSM were recruited in the intervention townships and 309 YMSM in the control townships. At end line, 267 (intervention) and 318 (control) YMSM were recruited. Coverage of the program was relatively low, with one-third of participants in the intervention townships having heard of the Link Up program by the end line. Comparing changes between baseline and end line, a greater proportion of HIV-negative or unknown status YMSM accessed HIV testing in the past 3 months in intervention townships (from 45.0% to 57.1%) compared with those in control townships (remained at 29.0%); however, this difference in the effect over time was not statistically significant in multivariate modeling (adjusted odds ratio: 1.45; 95% confidence interval: .66-3.17). Qualitative findings showed that the intervention was acceptable to YMSM. CONCLUSIONS: Overall, the intervention was perceived as acceptable. Although not statistically significant, results showed some trends toward improvements among YMSM in accessing HIV testing services and HIV-related knowledge. The modest coverage and short time frame of the evaluation likely limits the ability for any significant behavioral improvements.
PURPOSE: Young men who have sex with men (YMSM) in Myanmar are disproportionately affected by HIV, with prevalence five times that of the general population. The Link Up project implemented an intervention using peer education and outreach providing education and counseling on health seeking around sexually transmitted infections and reproductive health, combined with focused clinic capacity building to improve the sexual and reproductive health of YMSM. This study aimed to evaluate the effectiveness and acceptability of the intervention. METHODS: Using a mixed-methods approach, and employing a quasi-experimental design, we conducted two quantitative repeat cross-sectional surveys in purposively selected control (no intervention) and intervention townships, before and after implementation of the Link Up intervention. Respondent-driven sampling was used to recruit YMSM aged 15-24 years, and study participants were administered a structured questionnaire assessing intervention exposure, health service access, knowledge of HIV, and sexual risk behavior. Focus group discussions were held to elicit perspectives on the use and acceptability of the health services and peer outreach. RESULTS: At baseline, 314 YMSM were recruited in the intervention townships and 309 YMSM in the control townships. At end line, 267 (intervention) and 318 (control) YMSM were recruited. Coverage of the program was relatively low, with one-third of participants in the intervention townships having heard of the Link Up program by the end line. Comparing changes between baseline and end line, a greater proportion of HIV-negative or unknown status YMSM accessed HIV testing in the past 3 months in intervention townships (from 45.0% to 57.1%) compared with those in control townships (remained at 29.0%); however, this difference in the effect over time was not statistically significant in multivariate modeling (adjusted odds ratio: 1.45; 95% confidence interval: .66-3.17). Qualitative findings showed that the intervention was acceptable to YMSM. CONCLUSIONS: Overall, the intervention was perceived as acceptable. Although not statistically significant, results showed some trends toward improvements among YMSM in accessing HIV testing services and HIV-related knowledge. The modest coverage and short time frame of the evaluation likely limits the ability for any significant behavioral improvements.
Authors: Sunil S Solomon; Allison M McFall; Gregory M Lucas; Aylur K Srikrishnan; Muniratnam S Kumar; Santhanam Anand; Thomas C Quinn; David D Celentano; Shruti H Mehta Journal: PLoS Med Date: 2017-11-28 Impact factor: 11.069
Authors: Matthew D Hickey; Thomas A Odeny; Maya Petersen; Torsten B Neilands; Nancy Padian; Nathan Ford; Zachary Matthay; David Hoos; Meg Doherty; Chris Beryer; Stefan Baral; Elvin H Geng Journal: Implement Sci Date: 2017-08-08 Impact factor: 7.327
Authors: Vanessa Veronese; Michael Traeger; Zaw M Oo; Thet T Tun; Nwe N Oo; Htay Maung; Chad Hughes; Alisa Pedrana; Mark Stoové Journal: J Int AIDS Soc Date: 2020-02 Impact factor: 5.396