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Background
Guys who possess intercourse with males (MSM) are conservatively believed to be significantly less than 1% of this population that is nigerian nationally account fully for about 20per cent of brand new HIV illness. We estimated the trend in HIV prevalence and determined correlates of HIV disease among MSM.
This research utilized information 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 this season and eight states in 2014. Each round utilized similar methodology and therefore enables contrast. Behavioral information were acquired utilizing a structured questionnaire that is pre-coded. Variations in categorical factors had been evaluated with Chi Square. Logistic regression ended up being utilized to determine facets related to HIV.
An overall total of 879, 1545 and 3611 MSM had been recruited in 2007, 2010 and 2014 correspondingly. Median age had been 22 years for 2007 and 2014 whilst it ended up being 24 years this season. About one-third of MSM in 2007 and 2014 and about two-fifths this year had involved in transactional intercourse. HIV prevalence increased from 14% in 2007 to 17percent this season to 23per cent in 2014 (p
Background
Globally, males who possess intercourse with males (MSM) remain disproportionately affected and infected by HIV 1, 2. Despite huge opportunities in worldwide HIV and expanded antiretroviral treatment (ART) programs which have led to significant decreases in HIV among other find latin brides https://yourbrides.us/latin-brides/ sub-populations (basic populace, feminine sex employees), HIV among MSM has remained for a sustained increase globally 1, 3. In high earnings nations, the trend of HIV epidemic was for a decrease except among MSM 1. Likewise, available data on HIV incidence and prevalence from low and middle-income nations declare that the HIV epidemic among gay, bisexual as well as other males who possess intercourse with males are for a markedly different and increasing trajectory 1,2,3. In the united states, brand new HIV infections among MSM happens to be believed to be increasing at 8% per year since 2001 1. Into the Amsterdam Cohort research among MSM, HIV acquisition increased from 1.0 per 100 person-years in 1992 to 2.0 per 100-person years in ’09 4, 5 while in China, from prospective studies that are cohort among MSM between 2005 and 2007, HIV purchase had been reported to own increased from 2.6 to 5.6 per 100 person-years 6,7,8,9.
Many studies of HIV acquisition and transmission among MSM have actually mostly dedicated to individual level risk factors including unprotected anal that is receptive, large number of lifetime male lovers, inserting and non-injecting medication usage and high viral load in the index partner 1. Nevertheless, specific degree danger facets alone, have now been proved to be inadequate to spell out the high transmission characteristics of HIV among MSM plus the divergence of MSM epidemics in comparison with HIV epidemics in other populations 1, 2. Other danger facets such as for instance biological, couple-network degree, community-level and structural motorists have already been founded to be relevant in knowing the persistent high transmission prices among MSM specially in the current presence of increased ART protection whereby brand brand brand new infections should decrease as a consequence of reduced odds of transmission due to the aftereffect of ART on viral load 2, 10, 11.
MSM in Nigeria are conservatively believed to be not as much as 1% regarding the Nigerian population yet nationally account fully for about 20per cent of new HIV infections 12. MSM are criminalized and stigmatized and this has further worsened in the last few years because of the passage of the Same-Sex Marriage Prohibition law of 2014 13,14,15,16,17. The new legislation included clauses that prohibited businesses from providing solutions to MSM and facilitation of meetings that support homosexual individuals, thus further criminalizing same-sex activities 12. Research indicates why these restrictive policies further restrict the coverage that is poor of avoidance, therapy, and care programs among MSM 12, 18,19,20,21. Extremely few HIV that is MSM-targeted prevention therapy and care solutions occur in a restricted wide range of states in Nigeria. This will be mainly as a result of restricted information on the size estimate of MSM across states along with restricted money for key population committed programs. Information on MSM are mostly from three rounds associated with the population-based Integrated Biological and Behavioural Surveillance Survey (IBBSS) conducted in, 2007, 2010, and 2014. This research aimed to evaluate the improvement in HIV prevalence and discover correlates of HIV among MSM in Nigeria. Proof out of this scholarly study will likely to be utilized by policy manufacturer and system supervisors for evidence-based choice making for HIV prevention among MSM in Nigeria.
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In 2007, just three states – Lagos, Kano and Cross River, had been within the IBBSS. This season, after increased knowing of the share of MSM to your HIV epidemic, one more three states had been contained in the IBBSS – the Federal Capital Territory (FCT), Kaduna and Oyo, whilst in 2014, Enugu and streams states had been included with the six states within the 2010 IBBSS. Hawaii selection ensured that five for the six zones that are geopolitical Nigeria had been represented within the study. Hence, the west that is southLagos and Oyo), south east (Enugu), south south (streams), north central (FCT) and north west areas (Kano and Kaduna) contributed into the study.
Sampling design and recruitment
Each round for the IBBSS utilized respondent sampling that is driven to your concealed nature of MSM and therefore permits contrast between and across rounds. Respondent sampling that is drivenRDS) is described at length in past studies 22, 23. Fleetingly, RDS is really a modified chain referral non-random sampling technique of recruitment that adjusts for the non-randomness utilizing a mathematical model that loads each sample recruited 23. Inclusion criteria had been male aged 16 years and above with a brief history of dental and/or anal intimate connection with another guy in the six months ahead of the study. Known MSM, designated as “seeds” began the chain of this recommendation community and make use of vouchers to recruit their peers in to the research. Ten seeds were chosen for every circular and seeds had been diversified by age, academic status and status that is socioeconomic. In order to prevent an over-representation of MSM with comparable characteristics, vouchers limited by three per recruit was utilized 23, 24. In addition, in order to prevent repeat enrollment, just one screener had been utilized, only 1 individual ended up being authorized to reimburse MSM that has effectively recruited their peers and just one location had been utilized. Each voucher had been yielded and redeemable N500 approx. $3 USD as a motivation for participating, with an extra N500 provided to a recruit for every single effective participant that is additional. Total settlement ended up being restricted to a maximum payment of n2000 approximately $12 USD. Test size when it comes to 2007 IBBSS ended up being approximated predicated on an thought HIV prevalence of 15%, a design effectation of 2.0 and amount of accuracy of 0.05. For the 2010 and 2014 IBBSS, test size ended up being projected to identify a 10% vary from the round that is subsequent.
Information collection
Structured interviewer that is close-ended questionnaires elicited information on socio-demographic traits, style of intercourse lovers and intimate danger actions. Interviews had been carried out in MSM organizations that are friendly in all the research states. Transactional sex had been examined both with feminine and male lovers. Kind of rectal intercourse practiced had been classified as “insertive penile intercourse” or penile that is“receptive” in past times a few months. HIV danger perception had been evaluated by asking MSM you are at risk of infection with HIV? ” with response options being “yes or no”“do you feel. Consistent condom use with intimate lovers during transactional and sex that is non-transactional evaluated by asking the concerns “how frequently did you or your male partner make use of a condom each time you had intercourse within the last 6 months? ” while condom usage at last intercourse ended up being examined by the concern “the last time you’d rectal intercourse did you or your partner make use of a condom? ”. Transactional sex had been examined by asking “have you received gift or money in return for intercourse within the last few a few months? ” Penned permission had been acquired from all individuals both for behavioural and biological aspects of the study.
Laboratory testing
Detection of HIV during most of the studies had been regularly carried out by rapid test utilizing whole bloodstream samples acquired from a hand prick. In line with the HIV that is national testing, a synchronous algorithm of Determine (Alere health, United States Of America) and Unigold (Trinity Biotech, Plc, Bray, Ireland) had been utilized to recognize HIV sero-positivity while status of discordant tests had been verified by using Stat Pak (Chembio Diagnostic techniques, ny, USA).