Sexual risk behaviours and HIV-1 prevalence among urban men who have sex with men in Cape Town, South Africa

Desmond Tutu HIV Centre, University of Cape Town, Cape Town 7705, South Africa.
Sexual Health (Impact Factor: 1.58). 06/2010; 7(2):149-53. DOI: 10.1071/SH09090
Source: PubMed

ABSTRACT Distinct homosexual and heterosexual HIV epidemics have previously been recognised in South Africa. However, linked HIV prevalence and self-reported sexual risk behaviour data have not been reported for men who have sex with men (MSM) in Cape Town since 1986.
We conducted a cross-sectional, anonymous, venue-based HIV risk behaviour and prevalence study of 542 self-identified MSM in greater Cape Town using a self-administered risk questionnaire and the OraSure testing device to asses HIV-1 prevalence.
This sample had an overall HIV prevalence of 10.4% (56/539). We found that self-identifying as gay, homosexual or queer (adjusted odds ratio (AOR) 4.5, 95% confidence interval (CI) 1.0-20.0) and reporting ever having had a sexually transmissible infection diagnosis (AOR 4.3, 95% CI: 2.3-8.3) were significantly predictive of testing HIV-1 positive, while reporting unprotected anal intercourse with a known HIV-negative partner (AOR 0.4, 95% CI: 0.2-0.9) was significantly protective.
These data suggest a mature epidemic with consistent high-risk taking among MSM in Cape Town, and significant associations of select self-reported risk behaviours and HIV-1 serostatus. There is a need for continued and robust HIV surveillance along with detailed risk behaviour trends over time to inform the development of targeted risk-reduction interventions for this population.

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    • "Studies with MSM in Africa continue to report that very few participants self-identify as transgender (cf. Baral et al. 2009; Burrell et al. 2010). Apart from the possibility that transgender individuals do not participate in research, and are 'inaccessible', this could also be attributed to the way in which researchers ask about gender identity and/or design their research. "
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    ABSTRACT: Transgender people are an important key population for HIV risk globally, and several studies have found HIV prevalence rates in transgender populations that are significantly higher than those among other key populations such as men who have sex with men (MSM). There is a lack of research on transgender populations in Africa, and at present, there is almost no data available on HIV prevalence and risk among transgender people on the continent. It is possible that the invisibility of transgender people in epidemiological data from Africa is related to the criminalisation of same-sex behaviour in many countries and the subsequent fear of negative repercussions from participation in research. Alternatively, transgender people may be being overlooked in research due to confusion among researchers about how to ask questions about gender identity. It is also possible that transgender populations have simply been ignored in research to date. Without research on transgender-specific HIV prevalence and risk, it is very difficult to know what interventions and services are needed for this risk population. Therefore, it is important that researchers, governments, Non Governmental Organisations (NGOs) and donor organisations begin to pay explicit attention to transgender people in their HIV-related research and programmes in Africa.
    SAHARA J: journal of Social Aspects of HIV/AIDS Research Alliance / SAHARA , Human Sciences Research Council 09/2012; 9(3):160-3. DOI:10.1080/17290376.2012.743829 · 0.81 Impact Factor
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    • "Engagement was sought with teams from Australia, England and South Africa as these were seen as being most applicable to our project in terms of study objectives and estimated HIV prevalence. Guidance was specifically requested over specimen storage and number code systems, pilot testing, selection of recruitment settings, marketing materials, fieldwork and participant recruitment (personal communication Joseph Debattista, Alisa Pedrana, Earl Burrell and Julie Dodds 2010). These exchanges enabled us to modify our methodological approach before engaging with local stakeholders. "
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    ABSTRACT: Introduction This report describes the methods of the first HIV prevalence study to be conducted among a community sample of men who have sex with men (MSM) in New Zealand. It highlights novel features of the project such as collecting oral fluid with indigenous MSM (Maori) and specimen collection at a large community fair day. It is intended to accompany the main summary paper [1] and to be read in conjunction with previous reports on the HIV behavioural surveillance programme in New Zealand (the Gay Auckland Periodic Sex Survey, or GAPSS) [2].
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    ABSTRACT: Men who have sex with other men (MSM) are a vulnerable population in Africa that has been insufficiently explored. Given the high rate of bisexuality among MSM (73% in the past year), it is important to understand their risk-taking behaviors regarding both men and women. A socio-behavioral survey was carried out in 2007 among 501 MSM recruited using the snowball sampling method. We explore in this article why a condom was not used during last sexual intercourse with a man and with a woman, taking into account the respondent's characteristics, type of relationship and the context of the sexual act. In the survey, 489 men reported that they had had sexual intercourse at least once with another man during the previous year, and 358 with a man and with a woman. The main risk factors for not using a condom at last sexual intercourse with another man were having sex in a public place (aOR = 6.26 [95%CI: 2.71-14.46]), non-participation in an MSM prevention program (aOR = 3.47 [95%CI: 2.12-5.69]), a 19 years old or younger partner (aOR = 2.6 [95%CI: 1.23-4.53]), being 24 years or younger (aOR = 2.07 [95%CI: 1.20-3.58]) or being 35 years or over (aOR = 3.08 [95%CI:1.11-8.53]) and being unemployed (aOR = 0.36 [95%CI: 0.10-1.25]). The last sexual intercourse with the respondent's wife was hardly ever protected (2%). With women, the other factors were a 15 years or younger partner (aOR = 6.45 [95%CI: 2.56-16.28]), being educated (primary: aOR = 0.45 [95%CI: 0.21-0.95], secondary or higher: aOR = 0.26 [95%CI: 0.11-0.62]), being a student (aOR = 2.20 [95%CI: 1.07-4.54]) or unemployed (aOR = 3.72 [95%CI: 1.31-10.61]) and having participated in a MSM prevention program (aOR = 0.57 [95%CI: 0.34-0.93]). Having participated in a prevention program specifically targeting MSM constitutes a major prevention factor. However, these programs targeting MSM must address their heterosexual practices and the specific risks involved.
    PLoS ONE 10/2010; 5(10). DOI:10.1371/journal.pone.0013189 · 3.53 Impact Factor
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