Holland Claire E, Papworth Erin, Billong Serge C, Kassegne Sethson, Petitbon Fanny, Mondoleba Valentin, Moukam Laure Vartan, Macauley Isaac, Eyene Ntsama Simon Pierre, Yomb Yves Roger, Eloundou Jules, Mananga Franz, Tamoufe Ubald, Baral Stefan D
Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, 21205, United States of America.
Central Technical Group, National AIDS Control Committee, Ministry of Public Health, Yaoundé, Cameroon.
PLoS One. 2015 Apr 23;10(4):e0122881. doi: 10.1371/journal.pone.0122881. eCollection 2015.
Men who have sex with men (MSM) are more likely to be living with HIV than other adult men in low- and middle-income countries. MSM experience barriers to accessing HIV services including a lack of available specialized care, and community-level stigma and discrimination. This study aims to examine the uptake of HIV services at non-governmental and community-based organizations (NGOs/CBOs) to identify ways to improve coverage of HIV prevention and treatment among MSM.
An Integrated Biological and Behavioral Surveillance (IBBS) survey was conducted in Yaoundé and Douala, Cameroon in 2011 using the respondent driven sampling (RDS) method to recruit and interview 239 MSM in Yaoundé and 272 MSM in Douala.
MSM in Yaoundé were statistically significantly more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they had any STI symptoms (aOR 2.17 CI 1.02-4.59. p=0.04), or if they had a larger MSM social network (aOR 1.02 CI 1.01-1.04. p<0.01). MSM in Douala were more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they were living with HIV (aOR 3.60 CI 1.35-9.60. p=0.01), or if they reported higher numbers of male sexual partners (aOR 1.17 CI 1.00-1.36. p=0.046). Compared to men in Douala, MSM in Yaoundé were significantly less likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months (aOR 0.22 CI 0 .14-0.34. p=<0.01).
With appropriate funding and resources, community-based organizations that provide care specifically for MSM can improve access to HIV prevention, treatment, and care services. Additionally, using social networks to reach MSM can connect greater numbers of the population to effective HIV interventions, which will improve health outcomes and decrease onward transmission of HIV.
在低收入和中等收入国家，与男性发生性关系的男性（男男性行为者）感染艾滋病毒的可能性高于其他成年男性。男男性行为者在获取艾滋病毒服务方面面临障碍，包括缺乏可用的专门护理以及社区层面的耻辱和歧视。本研究旨在调查非政府组织和社区组织（非政府组织/社区组织）对艾滋病毒服务的接受情况，以确定改善男男性行为者艾滋病毒预防和治疗覆盖率的方法。
2011年在喀麦隆雅温得和杜阿拉进行了一项综合生物和行为监测（IBBS）调查，采用应答驱动抽样（RDS）方法招募并采访了雅温得的239名男男性行为者和杜阿拉的272名男男性行为者。
在雅温得，男男性行为者在过去12个月内如果有任何性传播感染症状（调整后的比值比为2.17，置信区间为1.02 - 4.59，p = 0.04），或者拥有更大的男男性行为者社交网络（调整后的比值比为1.02，置信区间为1.01 - 1.04，p < 0.01），则在统计学上更有可能获得非政府组织/社区组织的服务或被外展工作者接触到。在杜阿拉，男男性行为者如果感染了艾滋病毒（调整后的比值比为3.60，置信区间为1.35 - 9.60，p = 0.01），或者报告有更多的男性性伴侣（调整后的比值比为1.17，置信区间为1.00 - 1.36，p = 0.046），则在过去12个月内更有可能获得非政府组织/社区组织的服务或被外展工作者接触到。与杜阿拉的男性相比，雅温得的男男性行为者在过去12个月内获得非政府组织/社区组织的服务或被外展工作者接触到的可能性显著更低（调整后的比值比为0.22，置信区间为0.14 - 0.34，p < 0.01）。
有了适当的资金和资源，专门为男男性行为者提供护理的社区组织可以改善艾滋病毒预防、治疗和护理服务的可及性。此外，利用社交网络接触男男性行为者可以使更多人群获得有效的艾滋病毒干预措施，这将改善健康结果并减少艾滋病毒的进一步传播。
