Ruiseñor-Escudero Horacio, Lyons Carrie, Ketende Sosthenes, Pitche Vincent, Anato Simplice, Tchalla Jules, Dometo Sodji, Baral Stefan
1 Department of Psychiatry, Michigan State University, East Lansing, Michigan.
2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
AIDS Res Hum Retroviruses. 2019 Jun;35(6):519-528. doi: 10.1089/AID.2018.0212.
High transmission probability of HIV during condomless anal sex puts men who have sex with men (MSM), transgender, and nonbinary individuals at increased risk of infection. This analysis aims to examine the socioeconomic, biological, and behavioral factors that are associated with consistent condom use (CCU) during insertive/receptive anal sex among MSM in the last month in the cities of Lomé and Kara, Togo. A total of 683 MSM ≥18 years of age were surveyed using respondent-driven sampling (RDS) for a cross-sectional survey in Lomé ( = 354; 51.8%) and Kara ( = 329; 48.2%). Participants completed a structured questionnaire and were tested for HIV and syphilis. Statistical analyses included RDS-weighted proportions, bootstrapped confidence intervals (CIs), and logistic regression models. When compared with Lomé, MSM in Kara had lower odds of CCU [adjusted odds ratio (aOR) = 0.29, 95% CI = 0.19-0.44]. Other factors associated with lower CCU were having an income of 2,000 Communaute Financiere Africaine (CFA)-12,000 CFA (aOR = 0.53, 95% CI = 0.36-0.77) or above 12,000 CFA (aOR = 0.34, 95% CI = 0.20-0.57), transgender women (aOR = 0.47, 95% CI = 0.25-0.92), and intersex gender (aOR = 0.42, 95% CI = 0.24-0.73), and ever being forced to have sex (aOR = 0.42, 95% CI = 0.21-0.82). Factors associated with CCU were identified in this study including older age (aOR = 1.49, 95% CI = 1.04-2.14) and having easy access to condoms (aOR = 2.70, 95% CI = 1.23-5.94) and very easy access to condoms (aOR = 2.73, 95% CI = 1.20-6.16). Reported condom use in this study was low, and several factors associated with CCU were identified including older age and access to condoms. This study highlights multiple barriers to preventive services experienced by MSM in Togo and therefore leveraging strategies to address these barriers may improve prevention of HIV and syphilis.
在无保护肛交期间，艾滋病毒的传播概率很高，这使得男男性行为者（MSM）、跨性别者和非二元性别者面临更高的感染风险。本分析旨在研究多哥洛美和卡拉市的男男性行为者在过去一个月进行插入式/接受式肛交时，与持续使用避孕套（CCU）相关的社会经济、生物学和行为因素。采用应答者驱动抽样（RDS）对洛美（n = 354；51.8%）和卡拉（n = 329；48.2%）的683名年龄≥18岁的男男性行为者进行了横断面调查。参与者完成了一份结构化问卷，并接受了艾滋病毒和梅毒检测。统计分析包括RDS加权比例、自抽样法置信区间（CI）和逻辑回归模型。与洛美相比，卡拉的男男性行为者持续使用避孕套的几率较低[调整后的优势比（aOR）= 0.29，95%CI = 0.19 - 0.44]。与持续使用避孕套几率较低相关的其他因素包括收入在2000非洲金融共同体法郎（CFA）- 12000 CFA之间（aOR = 0.53，95%CI = 0.36 - 0.77）或高于12000 CFA（aOR = 0.34，95%CI = 0.20 - 0.57）、跨性别女性（aOR = 0.47，95%CI = 0.25 - 0.92）、双性人（aOR = 0.42，95%CI = 0.24 - 0.73）以及曾被迫发生性行为（aOR = 0.42，95%CI = 0.21 - 0.82）。本研究确定了与持续使用避孕套相关的因素，包括年龄较大（aOR = 1.49，95%CI = 1.04 - 2.14）、容易获得避孕套（aOR = 2.70，95%CI = 1.23 - 5.94）和非常容易获得避孕套（aOR = 2.73，95%CI = 1.20 - 6.16）。本研究中报告的避孕套使用率较低，并且确定了几个与持续使用避孕套相关的因素，包括年龄较大和获得避孕套的情况。本研究突出了多哥男男性行为者在预防服务方面面临的多重障碍，因此利用策略来解决这些障碍可能会改善艾滋病毒和梅毒的预防工作。
