High HIV risk in a cohort of male sex workers from Nairobi, Kenya.
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Date
2013-12Author
McKinnon, LR
Gakii J, G
Juno, JA
Izulla, P
Munyao, J
Ireri, N,
Kariuki, CW
Shaw, SY
Nagelkerke, NJ
Gelmon, L
Musyoki, H
Muraguri, N
Kaul, R
Lorway, R
Kimani, J.
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
OBJECTIVES:
Men who have sex with men (MSM) are at high risk of HIV-1 acquisition and transmission, yet there remains limited data in the African context, and for men who sell sex to men (MSM SW) in particular.
METHODS:
We enrolled 507 male sex workers in a Nairobi-based prospective cohort study during 2009-2012. All participants were offered HIV/STI screening, counselling and completed a baseline questionnaire.
RESULTS:
Baseline HIV prevalence was 40.0% (95% CI 35.8% to 44.3%). Prevalent HIV infection was associated with age, less postsecondary education, marijuana use, fewer female partners and lower rates of prior HIV testing. Most participants (73%) reported at least two of insertive anal, receptive anal and insertive vaginal sex in the past 3 months. Vaginal sex was reported by 37% of participants, and exclusive MSM status was associated with higher HIV rates. Condom use was infrequent, with approximately one-third reporting 100% condom use during anal sex. HIV incidence was 10.9 per 100 person-years (95% CI 7.4 to 15.6). Predictors of HIV risk included history of urethral discharge (aHR 0.29, 95% CI 0.08 to 0.98, p=0.046), condom use during receptive anal sex (aHR 0.05, 95% CI 0.01 to 0.41, p=0.006) and frequency of sex with male partners (aHR 1.33/sex act, 95% CI 1.01 to 1.75, p=0.04).
CONCLUSIONS:
HIV prevalence and incidence were extremely high in Nairobi MSM SW; a combination of interventions including increasing condom use, pre-exposure prophylaxis and access to effective treatment is urgently needed to decrease HIV transmission in this key population.
Citation
Sex Transm Infect. 2013 Dec 13. doi: 10.1136/sextrans-2013-051310. [Epub ahead of print]Publisher
Universty of Nairobi
Collections
- Faculty of Health Sciences (FHS) [10387]