title: The use of vouchers in HIV prevention, referral treatment, and care for young MSM and young transgender people in Dhaka, Bangladesh: experience from 'HIM' initiative.
abstract: BACKGROUND
  The study described the effectiveness of a voucher scheme to access sexual and reproductive health and HIV services among young MSM and transgender people aged 15-24 years in Dhaka, Bangladesh, a country with HIV prevalence of less than 0.1%.
  
  
  METHODS
  Descriptive and analytical methods were used to assess the net effects of biodemographic factors of the respondents on the voucher scheme. Effectiveness of the scheme was contextualized as target population coverage, and turnaround time of voucher redemption to access services.
  
  
  CONCLUSIONS
  A total of 210 (87.9%) out of the 239 vouchers distributed were redeemed. The mean age of the identified young people was 19.6 years (SD = +2.6 years). The coverage of the scheme against the target population of 200 young MSM and 936 young transgender people was 88% (n = 175) and 4% (n = 35) respectively, with P < 0.001. The median turnaround time for voucher redemption was 7 days. The predictors of voucher turnaround time were age, education, and population group (P < 0.001). HIV testing and counselling was accessed by 160 (76%) respondents, one was positive and linked to antiretroviral treatment and 110 (52%) were diagnosed and treated for sexually transmitted infections.
  
  
  CONCLUSIONS
  The voucher scheme was effective in linking young MSM with sexual and reproductive health and HIV services in Dhaka, Bangladesh. The findings are consistent with the low HIV prevalence in the country. The scheme is, however, not optimal for linking young transgender people with services.
authors.affiliation: aHIV Section, United Nations Children's Fund, New York City, New York, USA bBandhu Social Welfare Society cHIV Programme, United Nations Children's Fund dNational AIDS/STD Programme, Ministry of Health and Family Welfare, Dhaka, Bangladesh eJohn Snow Inc., Arlington, Virginia, USA fHIV Programme, UNICEF Bangladesh, Dhaka, Bangladesh.
authors.forename: Tajudeen O
authors.initials: TO
authors.lastname: Oyewale
authors.forename: Shale
authors.initials: S
authors.lastname: Ahmed
authors.forename: Farid
authors.initials: F
authors.lastname: Ahmed
authors.forename: Mona
authors.initials: M
authors.lastname: Tazreen
authors.forename: Ziya
authors.initials: Z
authors.lastname: Uddin
authors.forename: Anisur
authors.initials: A
authors.lastname: Rahman
authors.forename: Kola A
authors.initials: KA
authors.lastname: Oyediran
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D063106:Transgender Persons / Q000706:statistics & numerical data*; D055815:Young Adult; D005260:Female