Emmanuel Faran, Ejeckam Chukwuebuka Chukwukadibia, Green Kalada, Adesina Adediran Adesola, Aliyu Gambo, Ashefor Gregory, Aguolu Rose, Isac Shajy, Blanchard James
Institute for Global Public Health, University of Manitoba, Winnipeg, Manitoba, Canada.
Program, Institute for Global Public Health, University of Manitoba (Nigeria Office), Abuja, Federal Capital Territory, Nigeria
Sex Transm Infect. 2025 Jan 29;101(1):10-16. doi: 10.1136/sextrans-2023-056067.
Nigeria has the fastest-growing HIV epidemic in West and Central Africa and key populations (KPs) bear a higher burden of HIV. This integrated biological and behavioural surveillance survey was conducted among female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID) and transgender (TG) populations to understand the changing dynamics of HIV to improve HIV prevention efforts in Nigeria.
Using a cross-sectional design, data were collected between October and November 2020 in 12 states, from randomly selected KP members using multistage probability sampling. Behavioural data were collected using a structured questionnaire followed by three rapid HIV tests. The study was approved by ethical review boards in Nigeria and Canada and all ethical considerations including maintaining the privacy and confidentiality of all study subjects were followed.
A total number of 17 975 KP members were interviewed, with a response rate of over 98.0%. A weighted HIV prevalence of 28.8% (95% CI 27.4% to 30.2%), 25.0% (95% CI 23.7% to 26.3%), 15.5% (95% CI 14.3% to 16.4%) and 10.9% (95% CI 9.9% to 11.8%) was found among TGs, MSMs, FSWs and PWIDs respectively. A high number of sex partners and consistent condom use were low for all types of KPs, especially with regular partners. Both MSM and TGs reported high rates of unprotected receptive anal intercourse ranging between 71.2% and 85.0%. Nearly 60.0% of PWID shared their used syringe with another PWID. Overall, 90.2% FSWs, 77.2% MSM, 81.9% TGs and 84.3% PWID were ever tested for HIV.
This study highlights the progressing trends of HIV prevalence among all KPs in Nigeria. A focused prevention approach is needed to control the emerging epidemic among KPs who constitute the epicentre of the HIV epidemic in Nigeria.
尼日利亚是西非和中非地区艾滋病毒疫情增长最快的国家，重点人群承受着更高的艾滋病毒负担。本次综合生物学和行为监测调查在女性性工作者、男男性行为者、注射吸毒者和跨性别者群体中开展，以了解艾滋病毒动态变化，改善尼日利亚的艾滋病毒预防工作。
采用横断面设计，于2020年10月至11月间在12个州，通过多阶段概率抽样从随机选取的重点人群成员中收集数据。行为数据通过结构化问卷收集，随后进行三次快速艾滋病毒检测。该研究获得了尼日利亚和加拿大伦理审查委员会的批准，并遵循了所有伦理考量，包括维护所有研究对象的隐私和保密性。
共采访了17975名重点人群成员，应答率超过98.0%。跨性别者、男男性行为者、女性性工作者和注射吸毒者中艾滋病毒加权患病率分别为28.8%（95%置信区间27.4%至30.2%）、25.0%（95%置信区间23.7%至26.3%）、15.5%（95%置信区间14.3%至16.4%）和10.9%（95%置信区间9.9%至11.8%）。各类重点人群的性伴侣数量多且始终坚持使用避孕套的比例较低，尤其是与固定伴侣。男男性行为者和跨性别者报告的无保护被动肛交率均很高，介于71.2%至85.0%之间。近60.0%的注射吸毒者与其他注射吸毒者共用用过的注射器。总体而言，90.2%的女性性工作者、77.2%的男男性行为者、81.9%的跨性别者和84.3%的注射吸毒者曾接受过艾滋病毒检测。
本研究突出了尼日利亚所有重点人群中艾滋病毒流行率的上升趋势。需要采取有针对性的预防措施，以控制构成尼日利亚艾滋病毒疫情中心的重点人群中的新发疫情。
