P43.13
Background: MSM in Kenya contribute 15% of new HIV infections yearly even when only 1% of men report same-sex sexual activity. There has been no conclusive participatory strategy that has engaged MSM nationally in developing HIV prevention responses for and by MSM. Kenyan MSM community organisations purposed to design and advocate for a combination package to advise planning, coordination and evaluation of HIV prevention, treatment, research and advocacy and development of the Kenya National AIDS Strategic Plan IV 2014–2019.
Methods: Between August and December 2013 with leadership of NACC and NASCOP and support from Ishtar MSM, IAVI and LVCT Health, participatory community discussions with 27 MSM-serving organizations designed a package of approaches to ending HIV among MSM.
Results: There was consensus that a combination package for MSM be defined and guidelines written. The package must prioritize strategies to improve outreach and access to HIV testing, adopting a find-test-treat-retain model to immediately link HIV-infected MSM to treatment regardless of CD4 count. Additionally, MSM be provided a broad range of prevention options including scaling up access to condoms and condom-safe lubricants, STI testing and treatment, post-rape care, PrEP and PEP. Legal reforms and democracy are critical to fighting stigma and discrimination in the public and among service providers. We must also increasingly and meaningfully engage MSM in critical decision-making in service delivery and research design and implementation, including on PrEP, vaccines and microbicides.
Conclusions: Funding, research and advocacy strategies informed by community insight should be prioritized to make HIV prevention investments efficient and sustainable. MSM-led health organizations should be supported to better sustain their work and to integrate and scale up biomedical interventions and research in their existing package of behavioural and structural interventions because of their community familiarity and grassroots outreach strategies.
