MSM Interventions

HIV/AIDS Practices / MSM Intervention and Services

Implementing HIV Prevention among Men who Have Sex with Men and Transgender Populations

         Evidence-based prevention innovations have proved that people living with HIV who have started treatment early enough can reduce the chance to transmit the virus to their partners by 96 percent. In this connection, it is also recommended that those who have tested negative must continue regular testing in order to monitor their health. This has led to a paradigm shift from the disaggregation between prevention and care and treatment to linkage between the two components so as to enable comprehensive intervention that includes knowledge, access to HIV/STIs testing, strengthening of the referral system that links those living with HIV to treatment.

        In addition to promotion of regular condom use, proactive healthcare services should also encourage MSM/TG to know their HIV status and to seek testing services. To achieve this, rapid testing should be expanded so as to increase the number of those who know their test results while referral system must be improved so that timely care and treatment can start. To ensure proper treatment, CD4 test must be performed in parallel with provision of knowledge on HIV transmission and promotion of health seeking behavior. The following principles explain the linkage between prevention and care and treatment.

        1.Demand creation for HIV testing should be enhanced using social marketing campaigns, social networks, quality drug stores networks, peer support system and training a new badge of volunteers.

        2.Supply and branding should incorporate quality services with the same standards, one-day rapid testing and CD4 testing services.

        Demand creation and supply and branding aim at reducing HIV infection among MSM/TG and encouraging people living with HIV to seek treatment and enjoy a better quality of life. Services that are provided with the same standards and quality will ensure trust in service provision and continued service utilization. Each service facility can choose either a small or a comprehensive service package as appropriate as follows.

  1. Quality HIV testing
  2. Quality HIV testing and STIs services
  3. Quality HIV testing, STIs services, Hepatitis – B vaccine and anal cancer screening
  4. Quality HIV testing, STIs services, Hepatitis – B vaccine, anal cancer screening


Outreach program comprises three essential principles.

         1.Search : MSM/TG can be difficult to reach especially those who have not disclosed their sexual orientation. Reaching out to them therefore must employ appropriate and effective approaches and tools such as a mapping of the target population both in terms of social networks and hotspots.

         2.Build relations: When the information on hotspots of the target population is available, the outreach workers’ main responsibility is to reach out to them and build rapport so as to gain their trust. Relationship building may not be successful by only one meeting, so meeting and relationship building must happen on a regular basis.

         3.Provide support: Some MSM/TG individuals may have difficulty or limitation in accession healthcare services. Outreach, therefore, aims to bring to them the help they need. They may need information on risk assessment, condom and lubricant supply, counseling or referral assistance to appropriate HIV/STIs services. The need for support or assistance must, however, come from the MSM/TG individuals themselves.

 An outreach program may be implemented in a variety of ways as follows: friendly network, hotspots, online social networks, community activities, condoms and lubricant distribution centers, friend centers, drop – in centers, IEC materials.    

 Source: National Guidelines for Implementing HIV Prevention among Men who Have Sex with Men and Transgender Populations, Bureau of AIDS, TB and STIs, year 2014



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