The study described the effectiveness of a voucher scheme to access sexual and reproductive health and HIV services among young MSM and transgender people aged 15–24 years in Dhaka, Bangladesh, a country with HIV prevalence of less than 0.1%.
Descriptive and analytical methods were used to assess the net effects of biodemographic factors of the respondents on the voucher scheme. Effectiveness of the scheme was contextualized as target population coverage, and turnaround time of voucher redemption to access services.
Results and discussion
A total of 210 (87.9%) out of the 239 vouchers distributed were redeemed. The mean age of the identified young people was 19.6 years (SD = +2.6 years). The coverage of the scheme against the target population of 200 young MSM and 936 young transgender people was 88% (n = 175) and 4% (n = 35) respectively, with P < 0.001. The median turnaround time for voucher redemption was 7 days. The predictors of voucher turnaround time were age, education, and population group (P < 0.001). HIV testing and counselling was accessed by 160 (76%) respondents, one was positive and linked to antiretroviral treatment and 110 (52%) were diagnosed and treated for sexually transmitted infections.
The voucher scheme was effective in linking young MSM with sexual and reproductive health and HIV services in Dhaka, Bangladesh. The findings are consistent with the low HIV prevalence in the country. The scheme is, however, not optimal for linking young transgender people with services.
Below: Distribution of turnaround time for voucher redemption to access sexual and reproductive health and HIV services among respondents
|Social Characteristics||Within 7 days||Within 14 days|
|Odds ratio exp β (95% CI)||P value||Odds ratio exp β (95% CI)||P value|
|20–24 years (rc)|
|15–19 years||0.37 (0.20–0.67)||0.001||0.33 (0.17–0.64)||0.001|
|Highest education level|
|None/primary education (rc)|
|Secondary education||0.42 (0.17–1.04)||0.059||0.44 (0.16–1.19)||0.105|
|Postsecondary education||0.34 (0.12–0.99)||0.047||0.20 (0.06–0.65)||0.008|
|Young MSM (rc)|
|Young transgender people||0.18 (0.03–0.97)||0.047||0.44 (0.09–2.04)||0.291|
|Students||1.16 (0.50–2.71)||0.732||1.85 (0.73–4.66)||0.196|
|Location of social network|
|Areas within and around tertiary institutions (rc)|
|Open parks and recreation centres||0.82 (0.39–1.73)||0.606||0.89 (0.39–2.01)||0.777|
|Municipal areas||2.64 (0.40–17.38)||0.313||0.53 (0.90–3.09)||0.477|
|Resource centres||0.67 (0.22–2.07)||0.483||0.42 (0.13–1.37)||0.152|
|Constant||5.24 (1.83–15.00)||0.002||12.05 (3.57–40.73)||0.00|
|Total number of cases||210||210|
|Model χ2 (df = 8)||21.47||21.85|
|Model significance (P value)||0.006||0.0052|
CI, confidence interval; rc, reference category.
Full article at: http://goo.gl/pWRV2T
By: Tajudeen O. Oyewale,a,† Shale Ahmed,b Farid Ahmed,f Mona Tazreen,f,∗ Ziya Uddin,c,† Anisur Rahman,d and Kola A. Oyedirane,‡
aHIV Section, United Nations Children's Fund, New York City, New York, USA
bBandhu Social Welfare Society
cHIV Programme, United Nations Children's Fund
dNational AIDS/STD Programme, Ministry of Health and Family Welfare, Dhaka, Bangladesh
eJohn Snow Inc., Arlington, Virginia, USA
fHIV Programme, UNICEF Bangladesh, Dhaka, Bangladesh
Correspondence to Tajudeen O. Oyewale, MBBS, MPH, PhD, UNICEF House, 3 UN Plaza, New York 10017, NY, USA. Tel: +1 212 326 7567;
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