Elia J Mmbaga1,2, Kåre Moen2, Germana H Leyna1, Rose Mpembeni1, Melkizedeck T Leshabari3. 1. Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. 2. Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway. 3. Department of Behavioural Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Abstract
INTRODUCTION: Limited studies and differential risk behaviors among men who have sex with men (MSM) in Africa calls for population-specific studies. We present results from the largest integrated biobehavioral survey among MSM in Africa to inform programming. METHODS: This was a cross-sectional study using respondent-driven sampling to recruit MSM aged 18 and above. Data on sociodemographic characteristics and HIV-related risks were collected and all participants were tested for HIV, herpes simplex virus type-2 (HSV-2), hepatitis-B virus (HBV), and syphilis RESULTS: : A total of 753 MSM with a mean age of 26.5 years participated in the study and 646 (85.7%) provided blood for biological testing. The prevalence of HIV was 22.3%, HSV-2 40.9%, syphilis 1.1%, and HBV 3.25%. Significant risk factors for HIV were age above 25, having no children [adjusted odds ratio (aOR), 2.4, 95% confidence interval (CI): 1.4 to 4.2], low HIV-risk perception (aOR, 2.6, 95% CI: 1.2 to 5.3), receptive position (aOR, 8.7, 95% CI: 1.2 to 5.3), and not using water-based lubricants (aOR, 2.6, 95% CI: 1.0 to 4.5) during the last anal sex. Also associated with HIV infection was, having sexual relationships with women (aOR, 8.0, 95% CI: 4.1 to 15.6), engaging in group sex (aOR, 3.8, 95% CI: 1.6 to 8.4), HSV-2 seropositivity (aOR, 4.1, 95% CI: 2.6 to 6.5), and history of genital ulcers (aOR, 4.1, 95% CI: 1.1 to 7.2). CONCLUSIONS: HIV infection and HSV-2 were highly prevalent among MSM. Low perceived HIV risk, practice of risk behaviors, and infection with HSV-2 were significant predictors of HIV infection. Behavioral interventions, HSV-2 suppressive therapies, and pre-exposure prophylaxis are highly needed.
INTRODUCTION: Limited studies and differential risk behaviors among men who have sex with men (MSM) in Africa calls for population-specific studies. We present results from the largest integrated biobehavioral survey among MSM in Africa to inform programming. METHODS: This was a cross-sectional study using respondent-driven sampling to recruit MSM aged 18 and above. Data on sociodemographic characteristics and HIV-related risks were collected and all participants were tested for HIV, herpes simplex virus type-2 (HSV-2), hepatitis-B virus (HBV), and syphilis RESULTS: : A total of 753 MSM with a mean age of 26.5 years participated in the study and 646 (85.7%) provided blood for biological testing. The prevalence of HIV was 22.3%, HSV-2 40.9%, syphilis 1.1%, and HBV 3.25%. Significant risk factors for HIV were age above 25, having no children [adjusted odds ratio (aOR), 2.4, 95% confidence interval (CI): 1.4 to 4.2], low HIV-risk perception (aOR, 2.6, 95% CI: 1.2 to 5.3), receptive position (aOR, 8.7, 95% CI: 1.2 to 5.3), and not using water-based lubricants (aOR, 2.6, 95% CI: 1.0 to 4.5) during the last anal sex. Also associated with HIV infection was, having sexual relationships with women (aOR, 8.0, 95% CI: 4.1 to 15.6), engaging in group sex (aOR, 3.8, 95% CI: 1.6 to 8.4), HSV-2 seropositivity (aOR, 4.1, 95% CI: 2.6 to 6.5), and history of genital ulcers (aOR, 4.1, 95% CI: 1.1 to 7.2). CONCLUSIONS:HIV infection and HSV-2 were highly prevalent among MSM. Low perceived HIV risk, practice of risk behaviors, and infection with HSV-2 were significant predictors of HIV infection. Behavioral interventions, HSV-2 suppressive therapies, and pre-exposure prophylaxis are highly needed.
Authors: James Stannah; Elizabeth Dale; Jocelyn Elmes; Roisin Staunton; Chris Beyrer; Kate M Mitchell; Marie-Claude Boily Journal: Lancet HIV Date: 2019-10-07 Impact factor: 12.767
Authors: Theo G M Sandfort; Karen Dominguez; Noel Kayange; Arthur Ogendo; Ravindre Panchia; Ying Q Chen; Wairimu Chege; Vanessa Cummings; Xu Guo; Erica L Hamilton; Michael Stirratt; Susan H Eshleman Journal: PLoS One Date: 2019-05-31 Impact factor: 3.240
Authors: Elia John Mmbaga; Germana Henry Leyna; Melkizedeck Thomas Leshabari; Britt Tersbøl; Theis Lange; Neema Makyao; Kåre Moen; Dan Wolf Meyrowitsch Journal: BMC Health Serv Res Date: 2019-11-06 Impact factor: 2.655
Authors: Alexander Mwijage Ishungisa; Dan Wolf Meyrowitsch; Elia John Mmbaga; Melkizedeck Thomas Leshabari; Kåre Moen Journal: J Int Assoc Provid AIDS Care Date: 2022 Jan-Dec
Authors: Jean Olivier Twahirwa Rwema; Carrie E Lyons; Sara Herbst; Benjamin Liestman; Julien Nyombayire; Sosthenes Ketende; Amelia Mazzei; Oluwasolape Olawore; Sabin Nsanzimana; Placidie Mugwaneza; Aflodis Kagaba; Patrick S Sullivan; Susan Allen; Etienne Karita; Stefan D Baral Journal: J Int AIDS Soc Date: 2020-10 Impact factor: 5.396
Authors: Mwijage Alexander Ishungisa; Kare Moen; Germana Leyna; Neema Makyao; Angela Ramadhan; Theis Lange; Dan Wolf Meyrowitsch; Mucho Mizinduko; Samuel Likindikoki; Melkzedeck Leshabari; Elia John Mmbaga Journal: BMJ Open Date: 2020-10-05 Impact factor: 2.692