Increasing HIV prevalence among males that have intercourse with males in Nigeria: a trend analysis
Guys who possess intercourse with males (MSM) are conservatively predicted to be lower than 1% of this Nigerian population yet nationally account fully for about 20per cent 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 year and eight states in 2014. Each round utilized similar methodology and hence enables contrast. Behavioral information were obtained making use of an organized questionnaire that is pre-coded. Variations in categorical factors had been evaluated with Chi Square. Logistic regression ended up being utilized to determine facets connected with 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 season had involved in transactional intercourse. HIV prevalence increased from 14% in 2007 to 17per cent this season to 23per cent in 2014 (p
Globally, males who’ve intercourse with guys (MSM) remain disproportionately infected and affected by HIV 1, 2. Despite huge assets in international 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. The trend of HIV epidemic has been on a decline except among MSM 1 in high income countries. Likewise, available information on HIV incidence and prevalence from low and middle-income nations declare that the HIV epidemic among gay, bisexual along with other males who possess intercourse with guys are on a markedly different and trajectory 1,2,3 that is increasing. In the united states, 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 purchase 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 cohort studies conducted 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 purchase and transmission among MSM have actually mostly dedicated to specific degree risk factors including unprotected anal that is receptive, large number of lifetime male lovers, inserting and non-injecting medication usage and high viral load into the index partner 1. But, specific degree danger facets alone, have now been been shown 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 various other populations 1, 2. Other danger facets such as for example biological, couple-network degree, community-level and structural motorists have now been established to be relevant in comprehending the persistent transmission that is high among MSM particularly in the clear presence of increased ART protection whereby brand new infections should decrease due to reduced possibility of transmission due to the aftereffect of ART on viral load 2, 10, 11.
MSM in Nigeria are conservatively calculated to be not as much as 1% for the population that is nigerian 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 modern times utilizing the passage of the Marriage that is same-Sex Prohibition of 2014 13,14,15,16,17. The law that is new clauses that prohibited businesses from providing solutions to MSM and facilitation of meetings that support homosexual people, thus further criminalizing same-sex activities 12. Research reports have shown 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 amount of states in Nigeria. That is mainly due to restricted information in the size estimate of MSM across states along with limited money for key population committed programs. Information on MSM are mostly from three rounds for the population-based incorporated 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. Proof using this scholarly research will likely to be employed by policy manufacturer and system supervisors for evidence-based choice making for HIV prevention among MSM in Nigeria.
In 2007, just three states — Lagos, Kano and Cross River, had been within the IBBSS. An additional three states were included in the IBBSS — the Federal Capital Territory best site for russian brides (FCT), Kaduna and Oyo, while in 2014, Enugu and Rivers states were added to the six states included in the 2010 IBBSS in 2010, following increased awareness of the contribution of MSM to the HIV epidemic. Their state selection ensured that five of this six zones that are geopolitical Nigeria had been represented when you look at the study. Therefore, the the west (Lagos and Oyo), south east (Enugu), south south (streams), north central (FCT) and north west areas (Kano and Kaduna) contributed towards the research.