Hiv-1 infection acquisition among MSM enrolled in sex worker outreach project (swop), Nairobi County.

Abstract

HIV incidence among MSM has increased in many regions in recent years threatening the progress towards ending the epidemic by 2030 despite prevention, treatment and care programs funded to reverse the HIV epidemic. To meet the targeted 75% reduction in HIV infections among key populations by 2020, adequate approaches need to be adopted that specifically address the key population needs. According to NACC report (2014) approximately 55% of MSM were receiving targeted HIV prevention, management and care interventions by the Ministry of Health and programmes such as SWOP and LVCT. Out of the 1011 MSM enrolled into SWOP by 2014, 447 were living with HIV and 111 of the sero-negative turned positive within a span of 3 years while the number of new infections in both female and male sex workers within the same period was 23 and 9 suggesting gaps in the HIV prevention strategies and/or implementation approach. The aim of the study was to screen all possible factors that increase the risk of MSM enrolled in SWOP acquiring HIV-1 infection and weight the effects of the identified factors. The findings of this study will serve as a guide for the SWOP implementers in coming up with targeted intervention strategies to avert this epidemic. The study objective was to determine risk factors that are associated with acquisition of HIV-1 infection in MSM enrolled in SWOP between 2005 and 2015. A case control study design was adopted to investigate factors contributing to increased risk of HIV-1 infection among men who have sex with men enrolled in SWOP. The MSM were recruited from enrolment records of the period between 1st January, 2015 and 31st January, 2016. A total of 324 men who have sex with men (MSM) were selected for this study. These men were enrolled into SWOP between 1st January, 2015 and 31st January, 2016 and were HIV negative at the time of enrolment. 81/324 (25.0%) men had turned sero-positive (Cases) by 1st February, 2017 while the rest remained negative (Controls). The study findings shows only history of foul smelling penile/anal discharge was found to be significant (OR=0.41, P=0.031), Therefore making it a significant risk factor of HIV acquisition among MSM. Therefore there is need for targeted interventions for MSM who also have history of STI. Future interventions tailored towards MSM should have a comprehensive approach that combines behavioural, medical and structural interventions.