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Individual and Sexual Network Predictors of HIV Incidence Among Men Who Have Sex With Men in Nigeria.

ABSTRACT: BACKGROUND:To date, HIV incidence studies among men who have sex with men (MSM) across sub-Saharan Africa have focused on studying sexual risk practices with less focus on sexual networks. SETTING:TRUST/RV368 conducted in Abuja and Lagos, Nigeria, recruited MSM using respondent-driven sampling and followed HIV-negative men for incident infection over 4 years. METHODS:Four-hundred forty-one HIV-uninfected MSM underwent a parallel rapid HIV testing algorithm every 3 months for up to 18 months. HIV incidence per 100 person-years (PY) and 95% confidence intervals (CIs) were estimated using Poisson regression. Individual and network characteristics were examined using multivariable Cox-proportional hazards regression adjusted and unadjusted for respondent-driven sampling weights. RESULTS:Among cohort members with a median age of 23 years [interquartile range (IQR): 20-27], 81 HIV infections occurred over 527 PY (incidence 15.4/100 PY; 95% CI: 12.3 to 19.0). The incidence rate was highest among 16-19 year olds as compared to those 25 years or older (30.9/100 PY; 95% CI: 22.1 to 45.3 vs. 6.9/100 PY; 95% CI: 4.2 to 10.9, respectively). Individual determinants included receptive partnerships, condomless sex, no history of testing for HIV, and rectal gonorrhea. Sexual networks were larger and consisted of an older sexual partner, although there was no clustering by recruitment networks. CONCLUSIONS:These HIV incidence data reinforce the unmet HIV prevention needs among young MSM in Nigeria. Even in the context of emerging HIV diagnostic and prevention strategies, structural challenges including stigma and criminalization of same-sex practices highlight the need for novel implementation approaches in the context of MSM-friendly services.

SUBMITTER: Nowak RG

PROVIDER: S-EPMC6519125 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Individual and Sexual Network Predictors of HIV Incidence Among Men Who Have Sex With Men in Nigeria.

Nowak Rebecca G RG Mitchell Andrew A Crowell Trevor A TA Liu Hongjie H Ketende Sosthenes S Ramadhani Habib O HO Ndembi Nicaise N Adebajo Sylvia S Ake Julie J Michael Nelson L NL Blattner William A WA Baral Stefan D SD Charurat Manhattan E ME

Journal of acquired immune deficiency syndromes (1999) 20190401 4

<h4>Background</h4>To date, HIV incidence studies among men who have sex with men (MSM) across sub-Saharan Africa have focused on studying sexual risk practices with less focus on sexual networks.<h4>Setting</h4>TRUST/RV368 conducted in Abuja and Lagos, Nigeria, recruited MSM using respondent-driven sampling and followed HIV-negative men for incident infection over 4 years.<h4>Methods</h4>Four-hundred forty-one HIV-uninfected MSM underwent a parallel rapid HIV testing algorithm every 3 months fo ...[more]

PMID: 30550487

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Project description:BackgroundHIV prevalence is increasing at a concerning rate among men who have sex with men (MSM) in China. Numerous studies have reported on levels of behaviors of Chinese MSM for different types of sexual partnerships, such as regular, non-commercial casual and commercial. This study aims to investigate the trends HIV incidence rates in relation to their risk sexual behaviors and partnership types among Chinese MSM.MethodThrough a comprehensive literature research from available English and Chinese literature databases, we collated relevant information of sexual behaviors of Chinese MSM. Further, with the utilization of a mathematical optimization approach, this study reconciles the distributions of sexual behavioral data over the last decade and infers the heterogeneous distributions of behavioral patterns among Chinese MSM. Distributions of high-risk behavioural indicators, including the number of sexual partners, number of sexual acts and condom usage in the past 6 months, are calibrated to available empirical data. Based on the resultant temporal trends in these distributions, the trends in HIV incidence rates associated with each type of partnership among MSM in China are also estimated.ResultsA total of 55 qualified articles have been identified. An average MSM has approximately 0.96 (95% CI, 0.59-1.18) regular, 3.75 (1.72-6.25) casual and 1.61 (0.97-2.78) commercial partners over a 6 month period and 4.33 (2.81-6.46), 1.42 (0.62-3.08), 1.48 (0.79-3.30) sexual acts per partnership respectively, corresponding to a total of 11.87 (8.87-15.25) acts. Condom usage has increased significantly during 2002-2010, at annual increases of 3.58% (2.98-4.12%), 5.55% (4.55-6.54%), and 5.03% (4.19-5.74%) for regular, casual and commercial partners respectively. These behavioral data implies an increase in HIV incidence of approximately 3.3-fold, from 2.04 (1.96-2.12) to 7.02 (6.71-7.35) per 1000 person-years during the same period. The proportion of new infections attributed to regular partnerships increased from 34% to 40%, whereas infections attributed to commercial partnerships reduced from 29% to 23% during 2002-2010.ConclusionRegular partnerships are the main contributor of new HIV cases among MSM in China, public health intervention strategies are required to increase condom usage and HIV testing rates among regular partners to curb the growing trend HIV incidence.

Dataset Information

Individual and Sexual Network Predictors of HIV Incidence Among Men Who Have Sex With Men in Nigeria.

Publications

Individual and Sexual Network Predictors of HIV Incidence Among Men Who Have Sex With Men in Nigeria.

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