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Complementary Recruitment Strategies to Reach Men Who Have Sex with Men and Transgender Women: The Experience of a Large Brazilian HIV Prevention Service


Different strategies have been used to reach men who have sex with men (MSM) and transgender women (TGW) for HIV prevention services. We described the characteristics of MSM and TGW attending a large HIV prevention service in Brazil according to different recruitment strategies or referrals. A total of 2713 individuals (2246[82.8%] MSM and 467[17.2%] TGW) attended the service. Among HIV-negative MSM and TGW, 74.6% and 82.8% were eligible for pre-exposure prophylaxis (PrEP), respectively. PrEP uptake among MSM and TGW was 56.4% and 39.1%, respectively. Participants were mostly referred by peers (43.6%), followed by web-based (24.1%) and venue-based recruitment (16.2%). More young and Black MSM were referred from venue-based recruitment, and web-based strategies more frequently referred MSM with higher education. TGW who were younger and had higher education were more frequently referred from venue-based recruitment. Web-based recruitment failed to reach TGW. Multiple strategies were complementary to reach diverse MSM and TGW populations.


Diferentes estrategias se han usado para alcanzar hombres que tienen sexo con hombres (HSH) y mujeres trans (MT) en los servicios preventivos del VIH. Describimos las características de HSH y MT que acudieron a un servicio de prevención del VIH en Brasil, de acuerdo con diferentes estrategias de reclutamiento. Un total de 2713 personas (2246[82.8%] HSH y 467[17.2%] MT) asistieron al servicio y aquellos con resultado negativo al VIH (74.6% de HSH y 82.8% de MT) fueron candidatos a la profilaxis preexposición, siendo iniciada por 56.4% y 39.1%, respectivamente. Las referencias al servicio vinieron de pares (43.6%), en línea (24.1%) o por algún sitio (16.2%). Mayoritariamente los HSH jóvenes y negros, y las MT jóvenes con educación superior fueron referidos de algún sitio; mientras que los HSH con educación superior fueron en línea. Este último reclutamiento no sirvió para las MT. Múltiples estrategias fueron complementarias para alcanzar HSH y MT.

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We would like to thank all study participants and the INI-Fiocruz HIV prevention service staff: Alexandre Nabor, Bianka Fernandes, Cristiane Castro, Daniel Waite, Edilene Bastos, José Roberto Grangeiro, Luana M. S. Marins, Luciana Kamel, Nilo M. Fernandes, Sandro Nazer. A special thanks to Judith Recht and Hamid Vega for proofreading.


Dr. Torres was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, #28/2018).

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Authors and Affiliations



DRBB, BH, VGV, BG, SWC and TST conceived and implemented the study. CJ, EC, JF, LM, TS and CS collected the data. DRBB, JF, LM, TS and CS performed study recruitment procedures. DRBB, CJ, EJ, LEC and TST analyzed the data and generated the figure and tables. LEC, BH, VGV, BG and SWC aided in the interpretation of results and its broader implications. DRBB, CJ, EJ and TST reviewed the literature and drafted the manuscript. All authors critically revised the manuscript for important intellectual content and approved the final version of the manuscript prior to submission.

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Correspondence to Thiago S. Torres.

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This study was approved by the INI-Fiocruz institutional review board (#CAAE 26095519.1.0000.5262).

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Bezerra, D.R.B., Jalil, C.M., Jalil, E.M. et al. Complementary Recruitment Strategies to Reach Men Who Have Sex with Men and Transgender Women: The Experience of a Large Brazilian HIV Prevention Service. AIDS Behav 26, 2643–2652 (2022).

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  • Men who have sex with men
  • Prevention
  • Transgender
  • PrEP
  • Recruitment
  • Brazil