Enrolment characteristics associated with retention among HIV negative Kenyan gay, bisexual and other men who have sex with men enrolled in the Anza Mapema cohort study

• Published in: Journal of the International AIDS Society Vol. 23; no. S6; pp. e25598 - n/a
• Main Authors: Kunzweiler, Colin, Bailey, Robert C, Okall, Duncan O, Graham, Susan M, Mehta, Supriya D, Otieno‐Nyunya, Boaz, Djomand, Gaston, Otieno, Fredrick O
• Format: Journal Article
• Language: English
• Published: Switzerland International AIDS Society 01.10.2020; John Wiley & Sons, Inc
• Subjects: Adolescent; Adult; Aftercare; AIDS research; care and treatment; Cohort Studies; cohort study; Cross-Sectional Studies; Evaluation; gay and bisexual men who have sex with men; GBMSM; Health aspects; Health attitudes; HIV; HIV infection; HIV infections; HIV Infections - prevention & control; HIV negative; Homosexuality, Male - statistics & numerical data; Humans; Kenya; Logistic Models; Male; missed follow‐up visits; MSM (Men who have sex with men); Patient Compliance; Prevention; Prospective Studies; Public health administration; retention; Risk Reduction Behavior; Sexual and Gender Minorities; Sexual Partners; Surveys and Questionnaires; Young Adult; Kenya; cohort study; missed follow-up visits; HIV; GBMSM; Kenya; gay and bisexual men who have sex with men; HIV negative; care and treatment; retention
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1002/jia2.25598

Introduction Most gay, bisexual and other men who have sex with men (GBMSM) live in rights‐constrained environments making retaining them in research to be as hard as recruiting them. To evaluate Anza Mapema, an HIV risk‐reduction programme in Kisumu, Kenya, we examined the enrolment sociodemographic, behavioural, psychosocial and clinical factors associated with missing two or more follow‐up visits for GBMSM participating in Anza Mapema. Methods Between August 2015 and November 2017, GBMSM were enrolled and followed in a prospective cohort study with quarterly visits over 12 months. At enrolment, men were tested for HIV and sexually transmitted infections and completed questionnaires via audio computer‐assisted self‐interview. Because the Kenya Ministry of Health recommends HIV testing every three to six months for GBMSM, the retention outcome in this cross sectional analysis was defined as missing two consecutive follow‐up visits (vs. not missing two or more consecutive visits). Multivariable logistic regression estimated the adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the associations of the enrolment characteristics with the binary outcome of retention. Results and discussion Among 609 enrolled HIV‐negative GBMSM, the median age was 23 years (interquartile range, 21 to 28 years), 19.0% had completed ≤8 years of education and 4.1% had resided in the study area <1 year at enrolment. After enrolment, 19.7% missed two consecutive follow‐up visits. In the final multivariable model, the odds of missing two consecutive follow‐up visits were higher for men who: resided in the study area <1 year at enrolment (aOR, 4.14; 95% CI: 1.77 to 9.68), were not living with a male sexual partner (aOR, 1.59; 95% CI: 1.01 to 2.50), and engaged in transactional sex during the last three months (aOR, 1.70; 95% CI: 1.08 to 2.67). Conclusions One in five men missed two consecutive follow‐up visits during this HIV prevention study despite intensive retention efforts and compensation for travel and participation. Participants with recent community arrival may require special support to optimize their retention in HIV prevention activities. Live‐in partners of participants may be enlisted to support greater engagement in prevention programmes, and men who engage in transactional sex will need enhanced counselling and support to stay in longitudinal studies.