"S*CK. F*#K. Test. Repeat" A scoping review of HIV testing among men who have sex with men (MSM) and transgender women (TGW) in Thailand

Over the past two decades, Human Immunodeficiency Virus (HIV) has spread rapidly among gay men, transgender women and male sex workers in Thailand, reaching epidemic levels. This study used a scoping review approach to create an overview of the existing literature about HIV testing among men who have sex with men (MSM) and transgender women (TGW) in Thailand. A total of 50 articles and conference abstracts, including a book chapter, were included in this review. The reviewed publications were predominantly drawing on quantitative studies and relatively recent, with all but one article published after 2010. The majority had their focus on the MSM population located in Bangkok, while only a few concentrated solely on the transgender population and on areas outside of the capital city. Thematic analysis revealed six main topics resonating through the majority of the collated material, namely (1) factors influencing HIV testing uptake, (2) prevalence of HIV testing, (3) prevalence of HIV, (4) changes in risk behaviors related to HIV testing, (5) Repeat HIV testing and Loss-to-follow-up and (6) strategies to increase the uptake of HIV testing. Several articles reported on the proportion of subjects who had ever tested for HIV, which varied between 30% and 81%. The prevalence of HIV infection also varied between studies, from 2.8% to 27%, depending on group, location and year. Undergoing an HIV test was shown that it increased the interest in getting tested for HIV regularly in the future, and it was shown to have an association with reduced HIV-risk behaviors. Thirteen strategies currently being implemented in the country to increase the uptake of HIV testing among MSM and TGW were enumerated, and these strategies were tailored to address the factors that influenced HIV testing uptake among this population. These factors were among the six main subtopics that emerged in the thematic analysis. Current programs such as the establishment of community-based MSM and TGW-friendly testing centers, enhanced peer mobilization approach, testing centers and mobile clinics at MSM hotspots, and mobilizing key-population members in providing HIV testing and counseling reflected integration of social science principles in the development of programs intended to increase the uptake of HIV testing. This scoping review confirmed that the existing literature on this field of interest, when organized and presented systematically, offers a detailed description of the aspects of HIV testing among these two unique high-risk populations in Thailand