Population Council, No. 16, Mafemi Crescent, Utako, Abuja, Nigeria.
Save the Children International, Abuja, Nigeria.
BMC Public Health. 2019 Sep 2;19(1):1201. doi: 10.1186/s12889-019-7540-4.
Men who have sex with men (MSM) are conservatively estimated to be less than 1% of the Nigerian population yet nationally account for about 20% of new HIV infection. We estimated the trend in HIV prevalence and determined correlates of HIV infection among MSM.
This study used data from respondent-driven sampling in three rounds of integrated biological and behavioral surveillance survey (2007, 2010 and 2014) and covered three states in 2007, six states in 2010 and eight states in 2014. Each round used similar methodology and thus allows for comparison. Behavioral data were obtained using a structured pre-coded questionnaire. Differences in categorical variables were assessed with Chi Square. Logistic regression was used to identify factors associated with HIV.
A total of 879, 1545 and 3611 MSM were recruited in 2007, 2010 and 2014 respectively. Median age was 22 years for 2007 and 2014 while it was 24 years in 2010. About one-third of MSM in 2007 and 2014 and about two-fifths in 2010 had engaged in transactional sex. HIV prevalence increased from 14% in 2007 to 17% in 2010 to 23% in 2014 (p < 0.0001). Factors associated with HIV include older age ≥ 25 years (adjusted odds ratio {AOR}:2.41; 95% CI:1.84-3.16); receptive anal sex (AOR:1.92; 95% CI:1.54-2.40) and history of sexually transmitted infections (AOR:1.26; 95% CI:1.02-1.55).
There's been a consistent and significant increase in HIV prevalence among MSM with about 10-percentage points relative increase per year over 7 years. Older MSM were more likely to be HIV positive and this may reflect their prolonged exposure to high risk sexual activities. Evidence based interventions are urgently needed to mitigate intra-group HIV transmission and propagation of HIV epidemic between MSM and the general population.
据保守估计，尼日利亚男性同性恋者（MSM）人数不到该国总人口的 1%，但却占全国新感染艾滋病毒人数的 20%左右。我们估计了 MSM 中艾滋病毒流行趋势，并确定了艾滋病毒感染的相关因素。
本研究使用了来自三个轮次的综合生物和行为监测调查的受访者驱动抽样数据（2007 年、2010 年和 2014 年），涵盖了 2007 年的三个州、2010 年的六个州和 2014 年的八个州。每一轮都使用了类似的方法，因此可以进行比较。行为数据是使用结构化的预编码问卷获得的。使用卡方检验评估分类变量的差异。使用逻辑回归确定与 HIV 相关的因素。
2007 年、2010 年和 2014 年分别招募了 879、1545 和 3611 名 MSM。2007 年和 2014 年的中位年龄为 22 岁，而 2010 年的中位年龄为 24 岁。大约三分之一的 MSM 在 2007 年和 2014 年以及大约五分之二的 MSM 在 2010 年进行过商业性性行为。艾滋病毒的流行率从 2007 年的 14%上升到 2010 年的 17%，再到 2014 年的 23%（p<0.0001）。与 HIV 相关的因素包括年龄≥25 岁（调整后的优势比{AOR}：2.41；95%可信区间：1.84-3.16）；接受性肛交（AOR：1.92；95%可信区间：1.54-2.40）和性传播感染史（AOR：1.26；95%可信区间：1.02-1.55）。
MSM 中的艾滋病毒流行率持续显著上升，7 年内每年增加约 10 个百分点。年龄较大的 MSM 更有可能感染艾滋病毒，这可能反映了他们长期处于高风险性行为中。迫切需要采取基于证据的干预措施，以减轻 MSM 群体内部的艾滋病毒传播和艾滋病毒在 MSM 与普通人群之间的传播。
