Ricardo Mendizábal-Burastero, MPH Colectivo Amigos contra el Sida Reaching the unreachable: MSM recruitment strategy using social networks to HIV prevention services in Guatemala city Ricardo Mendizábal-Burastero, MPH Colectivo Amigos contra el Sida

Context Guatemala 16.2 million people 109,000 estimated MSM population Guatemala Department 21% of country’s population 17 municipalities including Guatemala City (GC) Most people commute to GC to work GC is a hookup place among MSM

10 years after... Background HIV prevalence in Guatemala City in 2003: 11.9% 10 years after... HIV prevalence in Guatemala City in 2013: 8.9% 1. Soto. Estudio Multicéntrico. 2003 2. MSPAS. ECVC 2012-2013

Why we cannot reach more MSM?

How we are trying to close the gap Community HTC Friendly hour service Improving access Face-to-face promotion Social stars advocates Social networks Mpowerment Volunteer networks Improving outreach

Using technology to reach more MSM By location GPS based apps Strategy Using peer promoter photograph Mobility Key messages: Free condoms STIs transmission We change location when a network starts to run out of non-tested MSM

Using technology to reach more MSM by social networks Friends-based apps Strategy Use of personal friend networks Social stars Volunteer Key topics HIV testing Free condoms We jump to a new friend network when the one we are using starts to run out of non-tested MSM

HIV cases sex ratio per year, Guatemala 2010-2015 1.2 1.3 1.4 1.3 1.4 2.1 Source: National Epidemiology Center

Impact of our intervention on diagnosing HIV cases CAS diagnosed 18% of male HIV cases in the country in 2015 28% of men HIV cases in Guatemala department In Guatemala are more than 350 HTC services in the country They report 98% of HIV tests Source: National Epidemiology Center

Lessons learned To be effective reaching MSM these key components should be considered: Adapting the services to the users Individual messages Avoid using automatic messages Customize message Inbox per inbox Usage of personal networks A real person is offering the HIV testing Diversify the virtual interventions GPS based Friend based

Next steps HIV risk estimation based on patterns of the social networks used Expand the strategy to other cities in the country

Special thanks to

This work has been possible by the great work of young (and not so young) committed to stop HIV Ricardo Mendizabal-Burastero rmendizabalb@gmail.com