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.
    Full-text · Article · Feb 2015 · Journal of Medical Virology
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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.
    Full-text · Article · Sep 2014 · Archives of Sexual Behavior
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    • "In Zambia, 33% of the MSM survey participants reported to have HIV infection compared to the national adult HIV prevalence of 15.2% (Zulu et al., 2006). In Senegal, where the national HIV prevalence is an estimated 1%, 22% of MSM surveyed were HIV positive (Wade et al., 2005). Apart from other factors which fuel HIV transmission among this group include lack of targeted preventive and surveillance programmes (van Griensven et al., 2009), unfriendly health care environment (Fay et al., 2011), culture and laws that are punitive to this group (Ntata et al., 2008). "
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    ABSTRACT: The HIV/ AIDS disease burden is disproportionately high among men who have sex with men (MSM) worldwide. If this group will continue to be ignored they will continue to be the focus of HIV infection to the general population. This study explored barriers impeding MSM utilizing the HIV related health services currently available. The objectives of the study were to: (i) determine how stigma and discrimination affect MSM attendance to HIV related health services; (ii) determine how health care worker’s (HCW’s) practices and attitudes towards MSM affect their attendance to HIV related health service; (iii) learn MSM’s perception towards seeking HIV related health services and other factors affecting accessibility of HIV related health services among MSM in Dar es Salaam, Tanzania. This was a descriptive study whereby qualitative methods were employed, using in-depth interviews for 50 individuals and focus group discussions for 5 groups which were conducted at PASADA premises, in Temeke district in 2012. After transcription data was read through, codes created were then collapsed into themes which were interpreted. The findings of this study show that majority of the study participants access HIV related health services in Dar es Salaam when they need to. However, they reported stigma and discrimination, lack of confidentiality and privacy, lack of availability and MSM friendly HIV related health services, financial challenges, poor practices and negative attitudes directed towards them by health workers, fears and lack of HIV knowledge among them as barriers for them to access these services. With these findings, there is an importance of enabling MSM to overcome the perceived stigma when seeking for HIV related health services. Also there is a need to conduct further research with regards to how HCW’s treat this group and their understanding on same sex practices.
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