Sergio Bautista-Arredondo

This session showed examples of multi-level interventions to improve engagement in HIV services and reduce sexual risk behaviors among adolescents and highlighted different individual, structural, and cultural barriers shape behavior among different populations.

In India, one study conducted using data from 2085 FSW from 30 community organizations (CO) showed that high CO strength improved financial security among FSW from 49% to 82%. In her study, Jessica Xavier found that individual-level interventions associated with changes in viral suppression include screenings for mental health, substance abuse, and food security. Also, referrals to HIV primary care and mental health care influence viral suppression. The Sawa Sawa intervention showed to effectively reduce community-level stigma and improve HIV testing among men in Mozambique. Also, in Africa, an increasing trend in the number of VMMC continued to climb among initiates. Finally, Elona Toska showed how consistent access to structural provisions in early adolescence is a critical aspect in delaying the initiation in high-risk sexual practices among adolescents. In particular, the effect of regular access to school feeding is higher among male than female.

This session highlighted the importance of multi-level strategies to improve HIV care among different populations. The presentations addressed culturally mindful services addressing individual and structural barriers for people to engage in HIV services. Addressing this broader social-structural context surrounding HIV is of particular importance among groups who experience inequality and discrimination – just as those shown in the session. More in-depth research on the pathways of the effect of the community and cultural barriers could serve to inform future interventions.