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 year 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 59per cent (56–61%) this season and 65per cent (63–66%) in 2014. An evaluation of this recency associated with HIV test revealed that over 70% stated that they received their HIV test within 12 months for the study, aided by the highest current tests reported in 2014 (79%; 77–81%).
Change in HIV prevalence
As shown in Table 1, HIV prevalence increased steadily between 2007 and 2014. From 14% (11–16%) in 2007, it risen up to 17per cent (15–19%) this year and 23per cent (22–34%) in 2014. Dining dining Table 2 shows HIV prevalence disaggregated by danger habits. When analysis ended up being restricted to simply states that took part in the 3 rounds regarding the IBBSS (Cross River, Kano and Lagos) HIV prevalence ended up being 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) although it increased among those aged 20–24 years, from 9per cent (7–12%) in 2007 to 21per cent (19–23%) in 2014.
When it comes to six states with information from at the least two rounds of IBBSS, there is upsurge in HIV prevalence in four regarding the states between your 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 year 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.
Facets 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 were more prone 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 in 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 prone to be HIV good. Education and transactional intercourse had been perhaps maybe perhaps not related to HIV among MSM in Nigeria.
This is the very first research to conduct a trend analysis of HIV prevalence and its own correlates among MSM in Nigeria and now we identified a handful of important findings. First, HIV prevalence has steadily increased in the long run with a 10-percentage point increase each year over 7 years. 2nd, the duty of HIV is greater among older MSM than younger people. Third, prevalence of STI in addition has increased within the years and contains significantly more than doubled from 7% this year to 17per cent in 2014. Fourth, although constant condom usage has increased 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 these were in danger for HIV and finally, in comparison to Cross River states, MSM who have a home in other states except Kano state had been very likely to be HIV good. These findings straight mirror the continuing state of HIV development for MSM in Nigeria and methods, policies and programs must certanly be built to deal with these gaps.
Amongst the very first and 2nd rounds of IBBSS in 2007 through 2010, feminine sex workers (FSW) had shown the prevalence that is highest of HIV among key populations in Nigeria. But, into the 3rd round of IBBSS in 2014, HIV prevalence among MSM (23%) exceeded compared to FSW (19%) that has been on a decrease from 37% to 19per cent and 30 to 9% among brothel and non-brothel based female intercourse employees correspondingly 25. The increase that is relative 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 ended up being sold or purchased along with non-transactional lovers. Nonetheless, while constant condom used in previous six months significantly more than doubled whenever sex had been offered, just 50% of these whom reported sex that is non-transactional condoms consistently. This implies that within MSM networks that are sexual there’s an elevated possibility of HIV transmission which might 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 in adition to that of these intercourse lovers, are employed by MSM as prevention approaches 1, 35. Serosorting requires the variety of HIV-concordant intercourse lovers, while sero-positioning involves sex that is choosing centered on serostatus 1. A report in Seattle, U.S. A, indicated that among recently contaminated MSM, 69% reported UAI with HIV-positive or status that is unknown compared to 32% in HIV uninfected settings 4, 36. The Swiss HIV cohort research stated that the predictor that is strongest of UAI had been 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 while the familiarity with HIV status of partners stays restricted within companies.
The reduced condom that is consistent in non-transactional intercourse may give an explanation for significant boost in self-reported STI between 2007 and 2014. Also, 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 use 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 medical and discrimination by health care workers are further worsened by the indegent capital of MSM targeted avoidance and therapy solutions in Nigeria. Between 2007 and 2012, significantly less than 5% of HIV financing ended up being devoted to most-at-risk populace much less than 5% aimed at allowing environment for HIV programs 39,40,41.
The rise in constant condom usage observed during transactional sex might give an explanation for low sensed danger of HIV among MSM. Significantly less than a 3rd of MSM felt vulnerable to HIV and because of the increased prevalence of HIV and STIs among MSM in Nigeria, efforts must certanly be built to increase HIV danger perception. The psychometric paradigm concept 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 behavior 50. Likewise, de Hoog et al. (2007) stated that once the extent of a danger was heightened, aside from the channel of interaction, there clearly was an associated positive and significant impact on intention and behaviour change 51. Behaviour modification interventions for HIV programs should always be made to increase the risk of HIV.