Ekouevi D K, Dagnra C Y, Goilibe K B, Tchounga B, Orne-Gliemann J, Salou M, Anato S, Prince-David M, Pitche V P
Département des sciences fondamentales et santé publique, faculté mixte de médecine et de pharmacie, Lomé, Togo; Inserm, unité 897, 33076 Bordeaux cedex, France; Centre africain de recherche en épidémiologie et sante publique (CARESP), Lomé, Togo.
Département des sciences fondamentales et santé publique, faculté mixte de médecine et de pharmacie, Lomé, Togo; Laboratoire de bactériologie-virologie, CHU de Tokoin, Lomé, Togo.
Rev Epidemiol Sante Publique. 2014 Apr;62(2):127-34. doi: 10.1016/j.respe.2013.11.074. Epub 2014 Mar 6.
Limited data are available on HIV infection among vulnerable populations in sub-saharan African countries, especially among men who have sex with men (MSM). The aim of this study was to estimate HIV prevalence and the factors associated with HIV infection among MSM in Togo in 2011.
A cross-sectional survey was carried out among MSM aged at least 18years old, living in Togo for at least 3months. They were recruited through the snowball method in six cities of Togo from November 2011 to January 2012. A survey form was used and an HIV screening test was proposed to the participants. The HIV prevalence was estimated with a 95% confidence interval. Univariate and multivariate analyses were performed to identify factors associated with HIV infection.
A total of 758 MSM were enrolled in this study, including 498 (67.5%) from Lomé, the capital of Togo. The median age was 24years with an interquartile range of [21-27years] and 271 MSM (35.7%) were students. The vast majority of MSM were Togolese (90.3%) and 14.6% were married or committed to a woman. HIV testing was accepted by 488 MSM (64.3%) but only 408 (53.8%) finally accepted a blood sample collection. The prevalence of HIV infection was 19.6% [95% confidence interval, 15.9-23.8]. In multivariate analysis, three factors were associated with HIV infection: living in Lomé, with an HIV prevalence of 29.8% against 4.3% in the other cities of Togo [adjusted odds ratio (aOR)=9.68; P<0.001]; having a good knowledge of HIV transmission modes (aOR=0.59; P=0.049); and not having a regular sex partner (aOR=1.69; P=0.049).
One MSM out of five was HIV-infected. Intervention programs targeting this vulnerable population are urgently needed, to reduce HIV incidence in Togo.
关于撒哈拉以南非洲国家弱势群体中的艾滋病毒感染情况，尤其是男男性行为者（MSM）中的感染情况，现有数据有限。本研究的目的是估计2011年多哥男男性行为者中的艾滋病毒流行率以及与艾滋病毒感染相关的因素。
对年龄至少18岁、在多哥居住至少3个月的男男性行为者进行了一项横断面调查。2011年11月至2012年1月期间，通过滚雪球法在多哥的六个城市招募了他们。使用了一份调查问卷，并向参与者提议进行艾滋病毒筛查检测。用95%置信区间估计艾滋病毒流行率。进行单因素和多因素分析以确定与艾滋病毒感染相关的因素。
本研究共纳入758名男男性行为者，其中498名（67.5%）来自多哥首都洛美。中位年龄为24岁，四分位间距为[21 - 27岁]，271名男男性行为者（35.7%）为学生。绝大多数男男性行为者是多哥人（90.3%），14.6%已婚或与女性有固定关系。488名男男性行为者（64.3%）接受了艾滋病毒检测，但最终只有408名（53.8%）同意采集血样。艾滋病毒感染率为19.6%[95%置信区间，15.9 - 23.8]。在多因素分析中，有三个因素与艾滋病毒感染相关：居住在洛美，艾滋病毒流行率为29.8%，而多哥其他城市为4.3%[调整优势比（aOR）=9.68；P<0.001]；对艾滋病毒传播方式有充分了解（aOR=0.59；P=0.049）；以及没有固定性伴侣（aOR=1.69；P=0.049）。
五分之一的男男性行为者感染了艾滋病毒。迫切需要针对这一弱势群体的干预项目，以降低多哥的艾滋病毒发病率。
