Only about a 3rd of participants (32%; 95% CI: 29–35%) felt these people were at an increased risk to HIV in 2007. This further reduced to 28% (25–30%) this season and stayed at 28% (26–29%) in 2014 with borderline importance (p = 0•055). Self-reported past HIV test increased steadily from 34% (31–37%) in 2007 to 59percent (56–61%) this year and 65per cent (63–66%) in 2014. An evaluation associated with recency regarding the HIV test revealed that over 70% stated that they received their HIV test within one year associated with research, utilizing the greatest present tests reported in 2014 (79%; 77–81%).
Improvement in HIV prevalence
As shown in Table 1, HIV prevalence increased steadily between 2007 and 2014. From 14% (11–16%) in 2007, it risen to 17per cent (15–19%) this season and 23per cent (22–34%) in 2014. Dining Table 2 shows HIV prevalence disaggregated by danger habits. Whenever analysis ended up being restricted to only states that took part in the 3 rounds regarding the IBBSS (Cross River, Kano and Lagos) HIV prevalence had been 13% (11–16%) this year and 25per cent (22–27%) in 2014.
The type of whom reported RAS just, HIV prevalence had been 19% (14–26%) in 2007, 23per cent (19–28%) this year and 24per cent (22–28%) in 2014. By age bracket, HIV prevalence ended up being stable among those aged 16–19 years (p = 0•953) whilst it increased among those aged 20–24 years, from 9per cent (7–12%) in 2007 to 21per cent (19–23%) in 2014.
For the six states with information from at the least two rounds of IBBSS, there was clearly escalation in HIV prevalence in four regarding the continuing states involving the two rounds, while two states recorded decreases. For Cross River state, HIV prevalence increased from 3% (1–5%) in 2007 to 6per cent (4–9%) this season and 11per cent (9–15%) in 2014 whilst in FCT (44% 36–53% vs. 30%; 26–34% and Kaduna state (23% 18–29% vs. 16% 13–19%) there is about 30% reduction in HIV prevalence between 2010 and 2014.
Factors connected with HIV prevalence among MSM
Table 3 outlines facets connected with HIV among MSM in Nigeria. In comparison to MSM aged 16–19 years, those aged 20–24 years and ? 25 years had been very likely to be HIV good (adjusted odds ratio AOR 1•40; 95% CI: 1•09–1.80) and (AOR 2•41; 95% CI: 1•84–3•16) respectively. In comparison to those that involved with IAS just, people who involved with RAS only (AOR 1•68; 95% CI: 1•11–2•54) or both IAS and RAS (AOR 1.71; 95% CI: 1.40–2.10) had been very likely to be HIV good. With Cross River state because the guide, MSM in Enugu state (AOR 1.89; 95% CI: 1•26–2.80), FCT (AOR: 4.23; 95% CI: 3.04–5.87), Kaduna state (AOR: 2.27; 95% CI: 1•59–3.23), Kano state (AOR: 1.97; 95% CI: 1•29–3.00), Lagos state (AOR: 6.66; 95% CI: 4.93–8.99) and streams state (AOR: 7.37; 95% CI: 4•96–10.94) were very likely to be HIV good. Education and transactional intercourse had been perhaps maybe perhaps not related to HIV among MSM in Nigeria.
This is the study that is first conduct a trend analysis of HIV prevalence and its particular correlates among MSM in Nigeria and now we identified a number of important findings. First, HIV prevalence has steadily increased in the long run with a point that is 10-percentage on a yearly basis over 7 years. 2nd, the burden of HIV is greater among older MSM than more youthful ones. Third, prevalence of STI in addition has increased throughout the years and has now a lot more than doubled from 7per cent this season to 17per cent in 2014. 4th, although constant condom usage has grown with transactional intercourse, the rise is less with non-transactional intercourse. Fifth, significantly less than 70% of MSM have actually ever been tested for HIV highlighting gaps that are major HIV avoidance intervention for MSM. Sixth, no more than a 3rd of MSM felt they certainly were at an increased risk for HIV and finally, in comparison to Cross River states, MSM who live in other states except Kano state were prone to be HIV good. These findings straight mirror the state of HIV development for MSM in Nigeria and methods, policies and programs must certanly be made to deal with these gaps.
Between your very very first and 2nd rounds of IBBSS in 2007 through 2010, female intercourse workers (FSW) had shown the greatest prevalence of HIV among key populations in Nigeria. Nevertheless, into the 3rd round of IBBSS in 2014, HIV prevalence among MSM (23%) exceeded compared to FSW (19%) that has been for a decrease from 37% to 19percent and 30 to 9% among brothel and non-brothel based female intercourse employees correspondingly 25. The general boost in HIV inc
Consistent condom use provides about 70–80% effectiveness in preventing HIV transmission 2, 32,33,34. In this research, constant condom usage increased from 2007 to 2014, whenever intercourse had been offered or purchased in accordance with non-transactional lovers. Nevertheless, while constant condom use in previous six months significantly more than doubled when intercourse ended up being offered, just 50% of the whom reported non-transactional intercourse utilized condoms consistently. This implies that within MSM intimate networks, there’s an elevated possibility of HIV transmission that may negate the increased utilization of condom during transactional intercourse. Sero-adaptation, including serosorting and strategic or sero-positioning, which depend on knowing one’s HIV status aswell as that of the intercourse partners, have already been utilized by MSM as prevention approaches 1, 35. Serosorting requires the variety of HIV-concordant sex lovers, while sero-positioning involves sex that is choosing centered on serostatus 1. A report in Seattle, U.S. A, revealed that among recently contaminated MSM, 69% reported UAI with HIV-positive russian brides free message or status that is unknown compared to 32% in HIV uninfected settings 4, 36. The Swiss HIV cohort study reported that the predictor that is strongest of UAI ended up being once you understand the HIV status of intimate lovers with constant condom usage being 89% between stable discordant couples and 48% between HIV-infected partners 4, 37. The part of seroadapation in Nigeria is unknown and much more therefore with significantly less than 70% of MSM ever being tested for HIV, it is not likely that this training is extensive because the familiarity with HIV status of partners continues to be restricted within companies.
The lower constant condom usage in non-transactional intercourse may give an explanation for significant rise in self-reported STI between 2007 and 2014. Moreover, those types of whom reported STIs, HIV prevalence increased between 2007 and 2014. Greater prevalence of STIs and undiscovered HIV infections are markers of suboptimal usage of clinically competent and health that is appropriate solutions that are in change reported to lessen HIV-related health-seeking behavior in African MSM 1, 38. The access that is suboptimal healthcare and discrimination by medical workers are further worsened by the indegent financing of MSM targeted prevention and treatment services in Nigeria. Between 2007 and 2012, significantly less than 5% of HIV money had been devoted to most-at-risk populace much less than 5% aimed at environment that is enabling HIV programs 39,40,41.
The rise in constant condom use observed during transactional intercourse may give an explanation for low identified chance of HIV among MSM. Significantly less than a 3rd of MSM felt susceptible to HIV and offered the increased prevalence of HIV and STIs among MSM in Nigeria, efforts needs to be meant to heighten HIV danger perception. The paradigm that is psychometric and a great many other social and wellness therapy theories 42,43,44,45,46,47,48,49 have identified risk perception as having a main part in determining behavior. A meta-analysis of danger assessment stated that interventions that successfully heightened the chance assessment within a person, lead to alterations in subsequent motives and behaviour 50. Likewise, de Hoog et al. (2007) stated that once the extent of the hazard had been heightened, aside from the channel of interaction, there was clearly an associated positive and effect that is significant intention and behaviour change 51. Behaviour modification interventions for HIV programs should really be made to increase the danger of HIV.