Social innovation in health is a community-engaged process linking social change and health improvement that draws on the diverse strengths of local individuals and institutions. This emerging field may provide novel and sustainable opportunities for improving sexual health in diverse Asian settings. In this article, we explore the application of these approaches to improve access to HIV/STI testing, prevention and treatment in Asia.

Men who have sex with men, transgender women and sex workers are disproportionately affected by the HIV epidemic around the world. In this article, we provide three frameworks aiming to maximise HIV interventions uptake specific to this key population. The frameworks are an integral part of demedicalisation, a crucial strategy to increase acceptability and accessibility of HIV interventions.

During the past decade, men who have sex with men (MSM) in Western urban areas have seen substantive decreases in new diagnoses of HIV infection. We do not know whether similar declines are present among MSM and transgender women (TGW) living in Southeast Asian cities. Of the 10 cities evaluated, only Bangkok reported a clear decrease in HIV prevalence among MSM. Few data were found for TGW, but where available, HIV prevalence was increasing.

HIV prevalence among female sex workers in Indonesia remains high and testing rates are low; however, there is limited qualitative research documenting these issues in Indonesia. This qualitative study explores the social influences enhancing HIV testing among this population. Strategies identified to address low testing rates in Indonesia include community- or workplace-based HIV testing with outreach support from health services, peer-led HIV testing within existing social networks, and working with bosses to implement HIV prevention strategies.

This paper reports on a community-controlled art gallery co-located with a sexual health mobile clinic in Yogyakarta, Indonesia. This study describes a program where the arts were a culturally sensitive and interesting public health communication tool to engage community with sexual health and HIV, and curiosity and informal pathways to the HIV treatment, testing and care. The arts are also powerful in creating shared understandings and challenging stereotypes and myths, positively affecting the structural environments that disempower vulnerable and marginalised people and communities.

We conducted a study in the Philippines, where the HIV/AIDS epidemic is concentrated among young men who have sex with men (MSM), to better understand adherence to antiretroviral therapy (ART) among this key population. In our study population of 462 HIV-positive patients, predominantly young MSM, 79% of patients were adherent to their ART. We found that longer time on treatment led to lower adherence, and that social support and substance use were important factors.

Studies have measured men who have sex with men (MSM) and transgender women (TGW) demand for pre-exposure prophylaxis (PrEP) services, which led to the design of the first ever PrEP program in Vietnam, Prepped for PrEP (P4P). In March 2017, PrEP services were offered in Ho Chi Minh City as part of the P4P demonstration project, enabling same-day enrolment in three key population-led clinics and four public clinics. P4P found PrEP to be highly acceptable among MSM and TGW. Continuation rates were relatively high for the first roll-out of PrEP; however, those aged ≤30 years were much more likely to discontinue services. Scaling-up PrEP through differentiated and community-led and engaged PrEP service delivery will be key to effectively increase access and uptake over the next 5 years.