Wade AS, Kane CT, Diallo PA, et al. HIV infection and sexually transmitted infections among men who have sex with men in Senegal

Programme National de Lutte contre le SIDA, Dakar, Sénégal.
AIDS (Impact Factor: 5.55). 01/2006; 19(18):2133-40. DOI: 10.1097/01.aids.0000194128.97640.07
Source: PubMed


No epidemiological study has been conducted on HIV and vulnerability to sexually transmitted diseases (STI) among men who have sex with men (MSM) in sub-Saharan Africa.
A survey including questionnaire, physical examination and detection of HIV and STI was carried out among 463 MSM, aged 18-52 years, recruited through the snowball technique in five urban sites throughout Senegal.
A total of 21.5% of men were found to be infected with HIV [95% confidence interval (CI), 17.8-25.6]. Active syphilis, positive serology for herpes simplex virus (HSV)-2, and polymerase chain reaction detection in urine of Chlamydia and gonorrhea infections were recorded in 4.8, 22.3, 4.1 and 5.4% of participants, respectively. Most respondents reported sex with women (94.1%). In the month preceding the interview, 24% reported at least one unprotected insertive anal intercourse with a male partner, 20% at least one unprotected receptive anal intercourse, and 18% at least one unprotected intercourse with a female partner. Genital examination showed that 5% of participants had at least one clinical sign of STI. Factors associated with HIV infection were age group, the reporting of more than nine lifetime male partners [odds ratio (OR), 3.76; 95% CI, 1.61-8.79], being a waiter or bartender (OR, 3.33; 95% CI, 1.41-7.84), and living in Dakar (OR, 3.33; 95% CI, 1.07-3.43).
Men who have sex with men in Senegal are highly infected with HIV and other STI. Intervention programs targeting this population are urgently needed, given their particular vulnerability and because infections are likely to disseminate into the general population given the high proportion of bisexual activity in this community.

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    • "R level should be applied to all populations with risk behav - iors and not only men who have sex with men . Increased concern about resurging HIV - 1 incidence among men who have sex with men had arisen on a global level , with high incidence rates reported in Asia , Africa , Latin America , and the former Soviet Union [ Bautista et al . , 2004 ; Wade et al . , 2005 ; Baral et al . , 2007 ; van Griensven , 2007 ; van Griensven et al . , 2009 ] . In Brazil , the prevalence of HIV - 1 infection in this population group raised from 0 . 56% in 2002 to 1 . 2% in 2007 [ Szwarcwald et al . , 2011 ] . In the current study , almost half of patients with TDR were men who have sex with men and some of them ( "
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    ABSTRACT: HIV-1 transmitted-drug-resistance and genetic diversity are dynamic and may differ in distinct locations/risk groups. In Brazil, increased AIDS incidence and related mortality have been detected in the Northeast region, differently from the epicenter in the Southeast. This cross-sectional study describes transmitted-dru- resistance and HIV-1 subtypes in protease/PR and reverse transcriptase/RT regions among antiretroviral naïve patients from Piauí State, Northeast Brazil. Among 96 patients recruited 89 (92.7%) had HIV-1 PR/RT regions sequenced: 44 females and 45 males, 22 self-declared as men who have sex with men. Transmitted-drug-resistance was investigated by CPR tool (Stanford HIV-1 Drug Resistance/SDRM). HIV-1 subtypes were assigned by REGA and phylogenetic inference. Overall, transmitted-drug-resistance rate was 11.2% (10/89; CI 95%: 5.8-19.1%); 22.7% among men who have sex with men (5/22; CI 95%: 8.8-43.4%), 10% in heterosexual men (2/20; CI 95%: 1.7-29.3%) and 6.8% in women (3/44; CI 95%: 1.8-17.4%). Singleton mutations to protease-inhibitor/PI, nucleoside-reverse-transcriptase-inhibitor/NRTI or non-nucleoside-reverse-transcriptase-inhibitor/NNRTI predominated (8/10): PI mutations (M46L, V82F, L90M); NRTI mutations (M41L, D67N) and NNRTI mutations (K103N/S). Dual class resistance mutations to NRTI and NNRTI were observed: T215L (NRTI), Y188L (NNRTI) and T215N (NRTI), F227L (NNRTI). Subtype B prevailed (86.6%; 77/89), followed by subtype F1 (1.1%, 1/89) and subtype C (1.1%, 1/89). B/F1 and B/C intersubtype recombinants represented 11.2% (10/89). In Piauí State extensive testing of incidence and transmitted-drug-resistance in all populations with risk behaviors may help control AIDS epidemic locally. J. Med. Virol. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    Journal of Medical Virology 02/2015; 87(5). DOI:10.1002/jmv.24087 · 2.35 Impact Factor
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    • "In some cases this leads men to self-medicate, seek treatment from unqualified health workers, or not be forthright about their symptoms when seeking treatment (Okal et al., 2009). African MSM also have restricted access to condom-compatible lubricants (Baral et al., 2009; Geibel et al., 2008; Geibel, Tun, Tapsoba, & Kellerman, 2010; Henry et al., 2010; Lane, Shade, et al., 2008; Niang et al., 2003; Okal et al., 2009; Wade et al., 2005), which are important tools to prevent painful RAI in addition to being essential HIV/STI prevention tools when used with condoms. "
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    ABSTRACT: Little is known about painful receptive anal intercourse (RAI) and its relationship to HIV risk and protective behaviors among men who have sex with men (MSM). The purpose of this study was to identify attributions for and responses to painful RAI among Black MSM in South African townships. In-depth interviews were conducted with 81 Black MSM (ages 20-39 years) who were purposively recruited from four townships. The semi-structured interviews addressed sexual behavior and identity, alcohol use, and safer sex. Pain during RAI was brought up by many participants without specific prompting from the interviewer. Analysis of the interview transcripts revealed that pain was a common feature of first RAI experiences but was not limited to first-time experiences. The participants attributed pain during RAI to partner characteristics, interpersonal dynamics, lack of lubricant, and alcohol use or non-use. The main strategies participants used to address pain during RAI were setting sexual boundaries and lubricant use; a small number of participants reported purposefully consuming alcohol to prevent the pain associated with RAI. Black South African MSM can be supported to reduce pain during RAI in ways that reduce their HIV/STI risk. Culturally specific sexual health education, supportive sexual health services, and improved access to condom-compatible lubricants are important components of HIV/STI interventions for this population.
    Archives of Sexual Behavior 09/2014; 44(2). DOI:10.1007/s10508-014-0365-4 · 3.53 Impact Factor
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    • "It was observed that the prevalence of HIV and syphilis infection among MSM in China was 6.5% (95% CI 5.6% to 7.4%) and 11.2% (95% CI 10.0% to 12.6%), respectively, which was lower compared to other countries and cities. For instance, the prevalence of HIV among MSM was 14.2% in Brazil, 10.6% in Kenya, 21.5% in Senegal, 9.0% in Indonesia, 14.7% in India, and 24.6% in Thailand [120–123]. "
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    ABSTRACT: Objectives: To figure out the most current prevalence of HIV and syphilis in MSM in China. Methods: A meta-analysis was conducted on the studies searched through PubMed, CNKI, and Wanfang published between 1 January 2009 and 11 April 2013. Results: Eighty-four eligible studies, either in Chinese or in English, were included in this review. The pooled prevalence of HIV and syphilis infection in MSM in China was 6.5% and 11.2%, respectively. The subgroup analyses indicated that the prevalence of HIV infection was higher in the economically less developed cities than that in the developed cities (7.5% versus 6.1%, P<0.05). In contrast, the prevalence of syphilis infection was lower in less developed cities than in developed cities (8.6% versus 15.1%). Studies with a sample size smaller than 500 had a lower prevalence of HIV and syphilis infection than those with a sample size greater than 500 (5.9% versus 7.2% for HIV; 11.0% versus 11.5% for syphilis, respectively). Conclusions: HIV and syphilis infection are prevalent in MSM in China. The different prevalence of HIV and syphilis infection between developing and developed cities underscores the need to target prevention strategies based on economic conditions.
    BioMed Research International 04/2014; 2014:620431. DOI:10.1155/2014/620431 · 2.71 Impact Factor
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