Online and venue-based recruitment strategies are complementary to reach high risk MSM for a large PrEP service in Rio de Janeiro, Brazil
BACKGROUND: New cases of HIV infections continue to increase among young MSM in Brazil. In order to mitigate the HIV epidemic, it is crucial to reach and engage young vulnerable MSM in PrEP services. This study compares online and venue-based strategies to recruit MSM to HIV prevention service in Rio de Janeiro, Brazil.
METHODS: MSM at high risk for HIV infection were recruited through venue-based and online strategies. Venue-based strategies consisted in peer educators recruitment in gay venues, referral by friends or health professionals and self-referral. Online strategies included advertisements on GSN dating apps (Hornet and Grindr) and social media (Facebook/Instagram) to increase PrEP and HIV awareness. We used chi-square test to compare the characteristics of MSM who attended the service through online and offline strategies.
RESULTS: From Mar-2018 to Oct-2019, 2246 MSM attended the service looking for HIV testing, HIV counseling and HIV prevention strategies (PEP and PrEP): 649(28.9%) recruited online and 1597(71.1%) through venue-based strategies. MSM recruited online were older (age median 28[IQR:24-35] vs. 27[IQR:23-34] years old, p=0.041), white (39.7% vs 35.6%, p=0.071) and of higher education (53.2% vs 36.0%, p<0.001) compared to MSM recruited through venue-based strategies. (Table). HIV prevalence was 10.7%(IQR:9.5-12.1%), higher among MSM recruited through venue-based strategies (12.0% vs. 7.7%, p=0.03). Among HIV-uninfected MSM, 74.6%(1496/2005) were eligible for PrEP, and the proportion was higher among MSM recruited online (77.8% vs. 73.3%, p=0.033). Among PrEP eligibles, PrEP uptake was 56.4% (844/1496), higher among those recruited online (62.9% vs. 53.5%, p<0.001). PEP initiation was higher among MSM recruited offline (18.3% vs. 8.2%, p<0.001).
| Venue-based 1597(71.1) | Online 649(28.9) | Total 2246(100) | p-value | ||
|---|---|---|---|---|---|
| Median age (years) | 27(IQR:23-34) | 28(IQR:24-35) | 27(IQR:23-34) | 0.041 | |
| Age (years) | 18-24 25-34 â?¥35 | 545(34.3) 729(45.9) 315(19.8) | 187(28.9) 312(48.2) 148(22.9) | 732(32.7) 1041(46.6) 463(20.7) | 0.003 |
| Race | White Non-white | 550(35.6) 995(64.4) | 246(39.7) 373(60.3) | 796(36.8) 1368(63.2) | 0.071 |
| Education | â?¤ Secondary school > Secondary school | 998(64.0) 561(36.0) | 297(46.8) 337(53.2) | 1295(59.1) 898(40.9) | <.001 |
CONCLUSIONS: Online and venue-based strategies are complementary to reach high risk MSM. While online strategies reached more MSM at higher HIV risk, venue-based strategies reached younger, non-white and lower educated MSM.
D.R.B. Bezerra * (1), T.S. Torres (1), L.E. Coelho (1), C. Jalil (1), E. Carvalheira (1), J.R. Grangeiro (1), D. Waite (1), T. Araujo (1), J. Freitas (1), C. Cerqueira (1), L. Monteiro (1), C. Oliveira (1), L. Kamel (1), N.M. Fernandes (1), S.w. Cardoso (1), B. Hoagland (1), V.G. Veloso (1), B. Grinsztejn (1)
(1) Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil