Population Services International, Washington, DC, USA.
J Acquir Immune Defic Syndr. 2013 Jun 1;63(2):221-7. doi: 10.1097/QAI.0b013e31828a3e60.
This study provides population-based estimates of HIV prevalence and factors associated with HIV infection among men who have sex with men (MSM) in 3 large cities in Nigeria. We aimed to increase the knowledge base of the evolving HIV epidemic among MSM, highlight risk factors that may fuel the epidemic, and inform future HIV prevention packages.
A total of 712 MSM, aged 18 years and older, living in Abuja, Ibadan, and Lagos were recruited using respondent-driven sampling. Participants completed a behavioral questionnaire and tested for HIV. Population-based estimates were obtained using RDSAT software. Factors associated with HIV infection were ascertained using multiple logistic regression adjusting for RDSAT individualized weights.
A high proportion of MSM reported high-risk behaviors, including unprotected anal sex with men (30-50%), unprotected vaginal sex with women (40%), bisexual behavior (30-45%), and never been tested for HIV (40-55%). The population-based estimates of HIV among MSM in the 3 cities were 34.9%, 11.3%, and 15.2%, respectively. In Abuja, HIV was significantly associated with unprotected sex and transactional sex. In Ibadan, HIV was significantly associated with unprotected sex and self-identified bisexual. In Lagos, HIV was significantly associated with the older age.
HIV prevalence among MSM in the 3 cities was 4-10 times higher than the general population prevalence and was behaviorally linked. In response to a complex set of risks and disadvantages that put African MSM at a greater risk of HIV infection, future interventions targeting MSM should focus on a comprehensive approach that combines behavioral, biomedical, and structural interventions.
本研究提供了基于人群的估计，说明了在尼日利亚三个主要城市中男男性行为者（MSM）中 HIV 流行率以及与 HIV 感染相关的因素。我们旨在增加对 MSM 中不断演变的 HIV 流行的知识基础，突出可能助长该流行的风险因素，并为未来的 HIV 预防方案提供信息。
共有 712 名年龄在 18 岁及以上的 MSM 参与者，来自阿布贾、伊巴丹和拉各斯，通过响应驱动抽样招募。参与者完成了行为问卷并接受了 HIV 检测。使用 RDSAT 软件获得基于人群的估计。使用多变量逻辑回归调整 RDSAT 个体加权，确定与 HIV 感染相关的因素。
很大一部分 MSM 报告了高风险行为，包括与男性无保护的肛交（30-50%）、与女性无保护的阴道交（40%）、双性恋行为（30-45%）和从未接受过 HIV 检测（40-55%）。这三个城市的 MSM 中基于人群的 HIV 估计患病率分别为 34.9%、11.3%和 15.2%。在阿布贾，HIV 与无保护的性行为和交易性行为显著相关。在伊巴丹，HIV 与无保护的性行为和自我认定的双性恋显著相关。在拉各斯，HIV 与年龄较大显著相关。
这三个城市的 MSM 中的 HIV 流行率比一般人群高 4-10 倍，与行为相关。为了应对使非洲 MSM 面临更大感染 HIV 风险的一系列复杂风险和劣势，针对 MSM 的未来干预措施应侧重于综合方法，将行为、生物医学和结构干预相结合。
