Community-Led Comprehensive HIV Facility for Men who have Sex with Men and Transgender Women: A Case Study of Rainbow Sky Association of Thailand

Abstract

The purpose of this study was to examine how an HIV service facility for men who have sex with men (MSM) and transgender women (TGW) is organized by the civil society, how this helps increase access to HIV services among these populations and whether its model can be demonstrated to be comprehensive HIV care that helps increase health outcomes. The study applied qualitative approaches, including reviews of relevant laws, policies and documents, and in-depth interviews to explore the modeling of RSAT Technological Clinic, Bangkok, Thailand, which is a community-led HIV service facility for MSM and TGW. In the first half of 2019, 4,917 MSM and 463 TGW clients were reached by the outreach team. There were 2,739 MSM and 305 TGW clients receiving HIV testing and 8.6% and 6.2% tested positive respectively. The accumulated number of MSM and TGW on anti-retroviral treatment was 1,669 and 105 people. 814 MSM and 41 TGW received pre-exposure prophylaxis. These services are operated by a civil society organization in the form of a technological clinic. Staff include those with formal education, in addition to community workers. The clinic has its own database, and technical support is provided by different stakeholder experts. This community-led HIV service model has helped increase access for MSM and TGW clients since it is organized by the community itself, which is more friendly in terms of staffing, service hours, service package and peer follow-ups. This model should be scaled up, reaching out to more MSM and TGW, which will help improve health outcomes and ensure equity and efficiency.