title: Potential Impact of Integrated Stigma Mitigation Interventions in Improving HIV/AIDS Service Delivery and Uptake for Key Populations in Senegal.
abstract: Men who have sex with men (MSM) and female sex workers (FSW) are consistently shown to have a higher burden of HIV compared with other adults in Senegal. This study, HIV Prevention 2.0, evaluates the impact of the 3-tiered integrated stigma mitigation interventions (ISMIs) approach to optimizing HIV service delivery for key populations in Senegal.
  
  
  
  Baseline assessment includes a questionnaire and biological testing for HIV. A proportion of participants enrolled into a 24-month longitudinal cohort with questionnaires and biological testing every 3 months. In these preliminary analyses, ISMIs are evaluated from participants in the cohort through uptake of HIV services and implementation outcomes.
  
  
  
  Overall, 724 MSM and 758 FSW participated in the baseline assessment. HIV prevalence is 30.2% (n = 219/724) among MSM and 5.3% (n = 40/758) among FSW. Fear of seeking health services among MSM is 17.7% (n = 128/724) at baseline, 10.5% (n = 18/172) at month 3, and 9.8% (n = 10/102) at month 6 (P < 0.004); and among FSW is 21.9% (n = 166/758) at baseline, 8.1% (n = 15/185) at month 3, and 10.7% (n = 18/168) at month 6 (P < 0.001). Overall, 63.9% (n = 62/97) of MSM and 82.5% (n = 118/143) of FSW agreed that the intervention is effective in addressing stigma; however, loss to follow-up was 41.1% among MSM and 10% among FSW.
  
  
  
  Baseline data reinforce the need for stigma mitigation interventions, combined with enhanced linkage and retention to optimize HIV treatment. Preliminary results show high levels of HIV-related risk determinants and suggest the potential utility of the ISMI to decrease perceived stigma relating to engagement in HIV prevention, treatment, and care services among key populations in Senegal.
authors.affiliation: *Department of Epidemiology, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; †Enda Sante, Dakar, Senegal; ‡Gaston Berger University, Saint-Louis, Senegal; §Division de La Lutte Contre Le Sida et Les IST, Ministry of Health, Dakar, Senegal; ‖Institut de Recherche en Santé, de Surveillance Epidemiologique et de Formations, Dakar, Senegal; and ¶USAID, Office of HIV/AIDS, Bureau for Global Health, Arlington, VA.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Lyons
authors.forename: Sosthenes
authors.initials: S
authors.lastname: Ketende
authors.forename: Daouda
authors.initials: D
authors.lastname: Diouf
authors.forename: Fatou M
authors.initials: FM
authors.lastname: Drame
authors.forename: Benjamin
authors.initials: B
authors.lastname: Liestman
authors.forename: Karleen
authors.initials: K
authors.lastname: Coly
authors.forename: Cheikh
authors.initials: C
authors.lastname: Ndour
authors.forename: Gnilane
authors.initials: G
authors.lastname: Turpin
authors.forename: Souleymane
authors.initials: S
authors.lastname: Mboup
authors.forename: Karim
authors.initials: K
authors.lastname: Diop
authors.forename: Coumba
authors.initials: C
authors.lastname: Toure-Kane
authors.forename: Delivette
authors.initials: D
authors.lastname: Castor
authors.forename: Nafissatou
authors.initials: N
authors.lastname: Leye-Diouf
authors.forename: Stefan
authors.initials: S
authors.lastname: Baral
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy / Q000821:virology; D006296:Health Services; D006297:Health Services Accessibility; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012675:Senegal / Q000453:epidemiology; D060386:Sex Workers / Q000706:statistics & numerical data*; D057545:Social Stigma; D055815:Young Adult