Uniformed Services University, Bethesda, Maryland, United States of America.
Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America.
PLoS One. 2020 Mar 2;15(3):e0229533. doi: 10.1371/journal.pone.0229533. eCollection 2020.
Knowledge of HIV risk factors and reduction strategies is essential for prevention in key populations such as men who have sex with men (MSM) and transgender women (TGW). We evaluated factors associated with HIV-related knowledge among MSM and TGW and the impact of engagement in care at trusted community health centers in Nigeria.
The TRUST/RV368 cohort recruited MSM and TGW in Lagos and Abuja, Nigeria via respondent driven sampling. During study visits every three months, participants underwent structured interviews to collect behavioral data, received HIV education, and were provided free condoms and condom compatible lubricants. Five HIV-related knowledge questions were asked at enrollment and repeated after 9 and 15 months. The mean number of correct responses was calculated for each visit with 95% confidence intervals (CIs). Multivariable Poisson regression was used to calculate adjusted risk ratios and CIs for factors associated with answering more knowledge questions correctly.
From March 2013 to April 2018, 2122 persons assigned male sex at birth were enrolled, including 234 TGW (11.2%). The mean number of correct responses at enrollment was 2.36 (95% CI: 2.31-2.41) and increased to 2.95 (95% CI: 2.86-3.04) and 3.06 (95% CI: 2.97-3.16) after 9 and 15 months in the study, respectively. Among 534 participants who completed all three HIV-related knowledge assessments, mean number of correct responses rose from 2.70 (95% CI: 2.60-2.80) to 3.02 (95% CI: 2.93-3.13) and then 3.06 (95% CI: 2.96-3.16). Factors associated with increased overall HIV-related knowledge included longer duration of study participation, HIV seropositivity, higher education level, and more frequent internet use.
There was suboptimal HIV-related knowledge among Nigerian MSM and TGW at that improved modestly with engagement in care. These data demonstrate unmet HIV education needs among Nigerian MSM and TGW and provide insights into modalities that could be used to address these needs.
了解艾滋病毒风险因素和减少策略对于男男性行为者（MSM）和跨性别女性（TGW）等关键人群的预防至关重要。我们评估了与 MSM 和 TGW 与艾滋病毒相关的知识相关的因素，以及在尼日利亚受信任的社区卫生中心参与护理的影响。
TRUST/RV368 队列通过回应驱动抽样在尼日利亚拉各斯和阿布贾招募 MSM 和 TGW。在每三个月一次的研究访问期间，参与者接受了结构化访谈以收集行为数据，接受了艾滋病毒教育，并获得了免费的避孕套和 condom 兼容润滑剂。在入组时和 9 个月和 15 个月后分别询问了 5 个与艾滋病毒相关的知识问题。每个访问的平均正确回答数均带有 95%置信区间（CI）。使用多变量泊松回归计算与正确回答更多知识问题相关的因素的调整风险比和 CI。
从 2013 年 3 月至 2018 年 4 月，共招募了 2122 名出生时被分配为男性的人，其中包括 234 名 TGW（11.2%）。入组时正确回答的平均数量为 2.36（95%CI：2.31-2.41），分别增加到 9 个月和 15 个月后的 2.95（95%CI：2.86-3.04）和 3.06（95%CI：2.97-3.16）。在完成所有三次艾滋病毒相关知识评估的 534 名参与者中，正确回答的平均数量从 2.70（95%CI：2.60-2.80）增加到 3.02（95%CI：2.93-3.13），然后增加到 3.06（95%CI：2.96-3.16）。与整体艾滋病毒相关知识增加相关的因素包括研究参与时间更长、艾滋病毒血清阳性、更高的教育水平和更频繁的互联网使用。
尼日利亚 MSM 和 TGW 的艾滋病毒相关知识不足，适度改善了参与护理的情况。这些数据表明，尼日利亚 MSM 和 TGW 存在未满足的艾滋病毒教育需求，并提供了有关可用于解决这些需求的模式的见解。
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