MSM AND INNOVATIONS FOR UPTAKE OF PREVENTION PRACTICES: Lessons for Rectal Microbicide introduction in Uganda

BACKGROUND: MARPS IN UGANDA, SOGIAH-Uganda, Empowered at Dusk and GALA Uganda collaborated to provide HIV/STIs prevention information through internet and telephone-based counselling to 125 persons for 24 months from July 2009-June 2011.

OBJECTIVE: We sought to determine frequently asked questions in order to develop a pocket size booklet targeting raising awareness on HIV and prevention practices.

DESIGN: This exercise investigated 125 persons. It was to utilise104 Saturdays for check-in using internet; 24 once a month call in/drop-in and; 8 quarterly support group meetings at two identified social meetings spaces in 2 suburbs in Kampala.

SETTING: This exercise utilised the internet, telephone and 2 social/talk spaces around 2 suburbs in Kampala.

PARTICIPANTS: The participants evaluated were; 25 MSM who were receptive partners (18-27 years); 12 insertive MSM (23-36 years); 35 male sex-workers who played both roles and; 53 internet based bisexual men (28 play a receptive role in same sex liaisons and 25 play both roles in a same sex liaison) and of these 43 had families.

INTERVENTION: 53 internet based participants subscribed to five interactive spaces on face-book and used skype; 37 MSM were accessible by phone for 18 months and; 35 male sex-workers had attended 6 sessions of mandatory support group meetings. This was an opportunity to provide information, counselling, guidance, preventive prophylactics and STIs check up for referral in case of infections.

MAIN OUTCOME MEASUREMENT: The primary outcomes measured were finding out whether the use of internet, telephone and talk/social spaces improves regular attendances and adherence to means of gaining understanding of sexuality and prevention practices against HIV/STIs for MSM.

RESULTS: 37 MSM were included with a median follow-up of 24 months. 7 MSM from the original cohort were lost to follow-up after 18 months. 37 MSM were referred to a friendly clinic for HIV/STIs check up and 8 had a median attendance of 5, the other 13 MSM had a median check up of 2, 7 were lost to follow up after 18 months and had checked up only one time. In the case of 35 male sex-workers, 3 of the 6 meetings were used as Sexual reproductive Health sessions where health workers were invited to give informed and guided answers to frequently asked questions. This helped demystify life threatening perceptions. The other 3 meetings were used to follow up on planned activities of grass-root groups.  The participating internet-based bisexual-MSM, 43 (27-52 years) had families and had a score of 104 attendances at the interactive social spaces. They all remarked positively on the various thematic messages around SRH, Microbicides, HIV, same-sex relations and life as a bisexual man in Uganda.10 bisexual-MSM (19-26 years) had a median score of 65 attendances.

LIMITATION: This was an exercise carried out to improve focus on Sexual reproductive health of same sex practicing Ugandans, but reliance on internet, telephone and actual attendance at meetings meant use of funds to pay for internet, airtime and transport-funds for a taxi which meant significant loss to follow-up.

CONCLUSION: Innovations to improve interface with MSM is an effective way to create demand for Sexual reproductive health answers and products such as new prevention technologies like lubricants, dental dams, finger cots and microbicides for Ugandan same sex practicing persons.