Community-Based HIV Testing and Counseling Interventions Among Men Who Have Sex with Men in the Philippines: A Scoping Review

Background: The Philippines is experiencing one of the fastest-growing HIV epidemics in the Asia-Pacific region, with men who have sex with men representing approximately 83% of new infections. Despite the availability of free HIV testing services, significant barriers including stigma, discrimination, and limited healthcare access continue to impede testing uptake among this key population. Community-based HIV testing and counseling has emerged as a promising strategy to address these barriers, yet comprehensive synthesis of evidence specific to the Philippine context remains limited. Objectives: This scoping review aimed to systematically map and synthesize existing evidence on the effectiveness of community-based HIV testing and counseling interventions compared to conventional facility-based testing in increasing HIV testing uptake, early diagnosis, and linkage to care among men who have sex with men in the Philippines and comparable settings. Methods: This scoping review was conducted following the Joanna Briggs Institute methodological framework and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search was conducted across PubMed, Scopus, CINAHL, and Google Scholar databases. Ten studies meeting inclusion criteria were selected for analysis. Quality assessment utilized the Joanna Briggs Institute critical appraisal tools and the Cochrane Risk of Bias tool for randomized controlled trials. Results: The ten included studies demonstrated that community-based HIV testing approaches achieved HIV testing uptake rates ranging from 56.4% to 88.8%, with HIV positivity rates between 9.8% and 13.4% among first-time testers. HIV self-testing demonstrated high acceptability with System Usability Scale scores of 82.5, indicating excellent usability. Significant barriers to facility-based testing included health facility-related stigma, with rural health units identified as the most stigmatizing settings. Pre-exposure prophylaxis awareness was 74.9% among participants, with education level, income, prior HIV testing, and peer discussions significantly associated with awareness. Conclusion: Community-based HIV testing and counseling interventions demonstrate superior effectiveness compared to facility-based approaches in reaching men who have sex with men populations in the Philippines. The integration of HIV self-testing, peer-led outreach, and culturally-sensitive service delivery models offers promising strategies for addressing the HIV epidemic. Healthcare administrators and policymakers should prioritize the scale-up of community-based testing approaches while addressing structural barriers including stigma and discrimination in healthcare settings.