Rising HIV prevalence among men who have sex with men in Nigeria: a trend analysis
Rising HIV prevalence among men who have sex with men in Nigeria: a trend analysis
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DOI：
10.1186/s12889-019-7540-4
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发表时间：
2019-09-02
影响因子：
4.5
通讯作者：
Nzelu, Charles
中科院分区：
文献类型：
--
作者：
Eluwa, George I. E.;Adebajo, Sylvia B.;Nzelu, Charles
据保守估计，尼日利亚男男性行为者（MSM）不到人口的1%，但在全国范围内，艾滋病毒新感染者约占20%。我们估计了艾滋病毒流行趋势，并确定了男男性接触者中艾滋病毒感染的相关因素。方法本研究采用2007年、2010年和2014年三轮生物和行为综合监测调查中受访者驱动的抽样数据，涵盖2007年的3个州、2010年的6个州和2014年的8个州。每一轮都使用类似的方法，因此可以进行比较。行为数据通过结构化的预编码问卷获得。分类变量的差异用x平方分布评估。使用逻辑回归来确定与HIV相关的因素。结果2007年、2010年、2014年共招募男男性行为者879人、1545人、3611人。2007年和2014年的中位年龄为22岁，而2010年为24岁。2007年和2014年，约三分之一的男男性接触者和2010年约五分之二的男男性接触过性交易。艾滋病毒流行率从2007年的14%上升到2010年的17%，再到2014年的23% （p < 0.0001）。与HIV相关的因素包括：年龄较大>= 25岁（调整后优势比{AOR}:2.41; 95% CI:1.84-3.16）；接受性肛交（AOR:1.92; 95% CI:1.54-2.40）和性传播感染史（AOR:1.26; 95% CI:1.02-1.55）。结论：男男性行为者的艾滋病毒感染率持续显著上升，7年来每年相对上升约10个百分点。年龄较大的男男性接触者更有可能是艾滋病毒阳性，这可能反映了他们长期接触高风险的性活动。迫切需要以证据为基础的干预措施，以减轻群体内艾滋病毒的传播以及男男性行为者与一般人群之间艾滋病毒流行病的传播。
Background Men who have sex with men (MSM) are conservatively estimated to be less than 1% of the Nigerian population yet nationally account for about 20% of new HIV infection. We estimated the trend in HIV prevalence and determined correlates of HIV infection among MSM. Methods This study used data 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 in 2010 and eight states in 2014. Each round used similar methodology and thus allows for comparison. Behavioral data were obtained using a structured pre-coded questionnaire. Differences in categorical variables were assessed with Chi Square. Logistic regression was used to identify factors associated with HIV. Results A total of 879, 1545 and 3611 MSM were recruited in 2007, 2010 and 2014 respectively. Median age was 22 years for 2007 and 2014 while it was 24 years in 2010. About one-third of MSM in 2007 and 2014 and about two-fifths in 2010 had engaged in transactional sex. HIV prevalence increased from 14% in 2007 to 17% in 2010 to 23% in 2014 (p < 0.0001). Factors associated with HIV include older age >= 25 years (adjusted odds ratio {AOR}:2.41; 95% CI:1.84-3.16); receptive anal sex (AOR:1.92; 95% CI:1.54-2.40) and history of sexually transmitted infections (AOR:1.26; 95% CI:1.02-1.55). Conclusion There's been a consistent and significant increase in HIV prevalence among MSM with about 10-percentage points relative increase per year over 7 years. Older MSM were more likely to be HIV positive and this may reflect their prolonged exposure to high risk sexual activities. Evidence based interventions are urgently needed to mitigate intra-group HIV transmission and propagation of HIV epidemic between MSM and the general population.