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Background

Guys that have intercourse with guys (MSM) are conservatively projected to be not as much as 1% of this population that is nigerian nationally account fully for about 20% of brand new HIV disease. We estimated the trend in HIV prevalence and determined correlates of HIV illness among MSM.

This research used information from respondent-driven sampling in three rounds of built-in biological and behavioral surveillance study (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 permits contrast. Behavioral information were hot latin mail order brides acquired making use of a structured pre-coded questionnaire. Variations in categorical factors had been examined 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 had been 24 years this season. About one-third of MSM in 2007 and 2014 and about two-fifths this year had involved with transactional intercourse. HIV prevalence increased from 14% in 2007 to 17% this year to 23per cent in 2014 (p

Background

Globally, males that have intercourse with guys (MSM) remain disproportionately infected and affected 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 sub-populations (basic populace, feminine intercourse employees), HIV among MSM has remained on a sustained increase globally 1, 3. In high earnings nations, the trend of HIV epidemic was on a decrease except among MSM 1. Likewise, available information on HIV incidence and prevalence from low and middle-income nations claim that the HIV epidemic among gay, bisexual as well as other males who possess intercourse with guys are for a markedly different and trajectory 1,2,3 that is increasing. In america, brand new HIV infections among MSM is calculated to be increasing at 8% per year since 2001 1. Within the Amsterdam Cohort research among MSM, HIV purchase increased from 1.0 per 100 person-years in 1992 to 2.0 per 100-person years during 2009 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 largely centered on specific degree risk facets including unprotected anal that is receptive, large number of lifetime male lovers, inserting and non-injecting medication usage and high viral load when you look at the index partner 1. Nonetheless, specific degree danger factors alone, have already been proved to be inadequate to describe the high transmission characteristics of HIV among MSM while 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 level, community-level and structural motorists have already been established become relevant in comprehending the persistent transmission that is high among MSM specially in the clear presence of increased ART protection whereby brand new infections should decrease because of reduced possibility of transmission due to the effectation of ART on viral load 2, 10, 11.

MSM in Nigeria are conservatively projected to be lower than 1% of this Nigerian population yet nationally account fully for about 20per cent of brand new HIV infections 12. MSM are criminalized and stigmatized and also 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 law that is new clauses that prohibited companies from supplying solutions to MSM and facilitation of meetings that support homosexual people, thus further criminalizing same-sex activities 12. Studies have shown why these restrictive policies further restrict the poor protection of HIV avoidance, treatment, and care programs among MSM 12, 18,19,20,21. Extremely few MSM-targeted HIV prevention, therapy and care solutions occur in a finite wide range of states in Nigeria. This really is mainly as a result of restricted data from the size estimate of MSM across states in addition to restricted financing for key population devoted programs. Information on MSM are mostly from three rounds for the population-based built-in Biological and Behavioural Surveillance Survey (IBBSS) conducted in, 2007, 2010, and 2014. This research aimed to evaluate the noticeable improvement in HIV prevalence and discover correlates of HIV among MSM in Nigeria. Evidence out of this scholarly research 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 contained in the IBBSS. This season, after increased understanding of the share of MSM to your HIV epidemic, yet another three states had been within the IBBSS – the Federal Capital Territory (FCT), Kaduna and Oyo, whilst in 2014, Enugu and streams states had been included with the six states contained in the 2010 IBBSS. Their state selection ensured that five regarding the six zones that are geopolitical Nigeria were 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 to your research.

Sampling recruitment and design

Each round associated with IBBSS utilized respondent sampling that is driven towards the concealed nature of MSM and therefore permits contrast between and across rounds. Respondent sampling that is drivenRDS) happens to be described at length in past studies 22, 23. Quickly, RDS is really a modified chain referral sampling that is non-random of recruitment that adjusts for the non-randomness employing 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 contact that is sexual another guy within the six months before the study. Known MSM, designated as “seeds” began the chain associated with recommendation use and network vouchers to recruit their peers to the research. Ten seeds were selected for every round and seeds had been diversified by age, academic status and status that is socioeconomic. To prevent an over-representation of MSM with comparable characteristics, vouchers limited by three per recruit was utilized 23, 24. In addition, to avoid perform enrollment, just one screener ended up being utilized, just one individual ended up being authorized to reimburse MSM that has effectively recruited his peers and just one location had been utilized. Each voucher ended up being redeemable and yielded N500 approx. $3 USD as a motivation for participating, with one more N500 directed at a recruit for every effective participant that is additional. Total settlement had been restricted to a compensation that is maximum of approximately $12 USD. Test size for the 2007 IBBSS ended up being approximated according to a thought HIV prevalence of 15%, a design aftereffect of 2.0 and degree of accuracy of 0.05. When it comes to 2010 and 2014 IBBSS, test size had been believed to identify a 10% vary from the subsequent round.

Information collection

Structured interviewer that is close-ended questionnaires elicited information on socio-demographic traits, kind of intercourse lovers and intimate danger actions. Interviews had been carried out in MSM friendly companies identified in each one of the research states. Transactional sex ended up being examined both with feminine and male partners. Kind of rectal intercourse practiced ended up being classified as “insertive penile intercourse” or penile that is“receptive” within the past a few months. HIV danger perception ended up being examined 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 sexual lovers during transactional and non-transactional intercourse ended up being examined by asking the questions “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 final intercourse had been examined by the concern “the last time you’d rectal intercourse do you or your partner make use of a condom? ”. Transactional sex ended up being evaluated by asking “have you received gift or money in return for intercourse within the last few a few months? ” Written permission ended up being acquired from all individuals both for behavioural and biological components of the study.

Laboratory testing

Detection of HIV during most of the studies ended up being regularly carried out by quick test utilizing blood that is whole acquired from a little finger prick. In line with the HIV that is national testing, a synchronous algorithm of Determine (Alere healthcare, United States Of America) and Unigold (Trinity Biotech, Plc, Bray, Ireland) ended up being utilized to spot HIV sero-positivity while status of discordant tests had been verified by using Stat Pak (Chembio Diagnostic techniques, ny, United States Of America).