Interventions for improving the uptake of HIV testing among men who have sex with men in sub-Saharan Africa: a systematic review

HIV testing is the foundation of the HIV cascade, informing treatment initiation and viral load sup-pression. It is particularly critical for key populations such as men who have sex with men (MSM), who face a disproportionate burden of HIV due to systemic barriers including stigma, discrimination, and legal hindrances. These challenges limit access to HIV testing and necessitate tailored interven-tions. This systematic review aimed to assess innovative strategies to improve HIV testing uptake among MSM in sub-Saharan Africa (SSA). Guided by the “Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)” guidelines, a comprehensive search of databases, organisa-tional websites, and manual sources was conducted for studies published from January 2000 onward. The review was registered with “International Prospective Register of Systematic Reviews” (CRD42022346821). Twenty-three studies focusing on MSM aged 18 and above in SSA were included from an initial pool of 4,248 records. The findings revealed effective approaches such as point-of-care testing, self-testing, and community-based models. Peer-led and community-driven strategies signifi-cantly enhanced testing uptake by improving accessibility and acceptability. However, persistent bar-riers such as stigma, discrimination, cost, limited counselling, and negative provider attitudes, under-mined intervention effectiveness. Hence, addressing these barriers is essential to ensure the success and sustainability of HIV testing strategies among MSM in SSA. The review contributes to the litera-ture by consolidating existing evidence, identifying critical gaps, and informing the development of effective, contextually appropriate interventions.