From the *Anova Health Institute, Johannesburg, South Africa; †School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa; ‡Division of Infectious Diseases & HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa; §Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa; and ¶Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
Sex Transm Dis. 2017 Dec;44(12):768-773. doi: 10.1097/OLQ.0000000000000679.
Men who have sex with men (MSM) are a key population, particularly vulnerable to sexually transmitted infections (STIs) and HIV, but there are limited data on health programs targeting MSM in Africa. This study aims to describe the utilization of nongovernmental organization-supported sexual health services for MSM at 2 public sector health facilities in Johannesburg, South Africa.
We retrospectively analyzed routine data over the period of January 2014 to June 2016. We report on service utilization for STI syndromes, HIV testing, and the antiretroviral therapy (ART) program.
Some 5796 men visited the facilities. Seven thousand one hundred eighty-eight STI episodes were managed, 68.2% (4903 episodes) of which were classified as male urethritis and 9.8% (704 episodes) as genital ulcers. Positivity yield for first-time HIV tests was 38.0% (205 positive test results) in MSM, compared with 14.1% (471 positive test results) in other men. At the end of the study, there were 1090 clients on ART, and 2-year retention was 82% (95% confidence interval, 78%-85%). There was no difference in retention between MSM and other men (P = 0.49).
This study is the first to show that sexual health services targeting MSM in Africa have managed to attract MSM and other men in need of STI and HIV care. The observed high HIV testing yield among MSM illustrates the relevance of MSM-focused services in the South African public health sector, and the good retention on ART demonstrates that high-quality care can be provided to MSM in our setting.
男男性行为者（MSM）是一个关键人群，特别容易感染性传播感染（STI）和 HIV，但在非洲，针对 MSM 的健康计划的数据有限。本研究旨在描述南非约翰内斯堡 2 家公立卫生机构中，非政府组织支持的 MSM 性健康服务的利用情况。
我们回顾性分析了 2014 年 1 月至 2016 年 6 月期间的常规数据。我们报告了 STI 综合征、HIV 检测和抗逆转录病毒治疗（ART）项目的服务利用情况。
共有 5796 名男性访问了这些设施。管理了 7188 例 STI 发作，其中 68.2%（4903 例）被归类为男性尿道炎，9.8%（704 例）为生殖器溃疡。初次 HIV 检测的阳性率在 MSM 中为 38.0%（205 例阳性检测结果），而在其他男性中为 14.1%（471 例阳性检测结果）。研究结束时，有 1090 名患者接受了 ART，2 年保留率为 82%（95%置信区间，78%-85%）。MSM 和其他男性的保留率没有差异（P=0.49）。
本研究首次表明，针对非洲 MSM 的性健康服务成功吸引了需要 STI 和 HIV 护理的 MSM 和其他男性。在 MSM 中观察到的高 HIV 检测阳性率说明了 MSM 为重点的服务在南非公共卫生部门的相关性，以及在我们的环境中可以为 MSM 提供高质量护理的良好保留率。
