Experiences around testing and linkage to HIV care among gay, bisexual and other men who have sex with men: qualitative findings from the patient-centered care project in the lake Victoria region of Kenya

Although the Kenyan Ministry of Health recognizes key populations in addressing the country's HIV epidemic, gay, bisexual, and other men who have sex with men (GBMSM) face challenges in HIV testing, linkage, and retention in care. This study aimed to inform the development of context-specific interventions to improve GBMSM's initiation in HIV care in Kenya. Drawing on in-depth semi-structured interview data from the Patient-Centered Care Project (PCCP), a qualitative study exploring the experiences of people with HIV (PWH) across the continuum of care, we focused on GBMSM aged ≥18 years with HIV in Homa Bay, Kisumu, and Siaya Counties. Data from 93 interviews conducted in 2017 (60 in- and 33 out-of-HIV care) were analyzed. Participants reflected on interpersonal (stigma, emotional support) and structural (distance of clinics, food and economic insecurity) challenges and identified valuable programs that could address these (GBMSM-focused support groups, economic opportunities, food supplementation, government support). These findings highlight how stigma (related to HIV and GBMSM identity) hinders access to HIV testing services and linkage to care. Creating inclusive healthcare environments and fostering opportunities for economic support and social connections are essential for improving engagement with HIV services.