Only about a 3rd of participants (32%; 95% CI: 29–35%) felt they certainly were in danger to HIV in 2007. This further reduced to 28% (25–30%) this year and stayed at 28% (26–29%) in 2014 with borderline significance (p = 0•055). Self-reported HIV that is previous test steadily from 34% (31–37%) in 2007 to 59per cent (56–61%) this year and 65per cent (63–66%) in 2014. An evaluation associated with recency associated with the HIV test indicated that over 70% stated that they received their HIV test within one year regarding the research, because of the greatest current tests reported in 2014 (79%; 77–81%).
As shown in Table 1, HIV prevalence increased steadily between 2007 and 2014. From 14% (11–16%) in 2007, it risen to 17% (15–19%) this season and 23per cent (22–34%) in 2014. Dining dining dining Table 2 shows HIV prevalence disaggregated by danger actions. Whenever analysis ended up being restricted to simply states that took part in the 3 rounds of this IBBSS (Cross River, Kano and Lagos) HIV prevalence had been 13% (11–16%) this season and 25per cent (22–27%) in 2014.
Those types of whom reported RAS just, HIV prevalence had been 19% (14–26%) in 2007, 23per cent (19–28%) this season and 24% (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 21percent (19–23%) in 2014.
When it comes to six states with information from at the least two rounds of IBBSS, there clearly was escalation in HIV prevalence in four for the 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 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% decline in HIV prevalence between 2010 and 2014.
Table 3 outlines facets related to HIV among MSM in Nigeria. In comparison to MSM aged 16–19 years, those aged 20–24 years and ? 25 years had been 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. When compared with people who involved with IAS just, people who engaged in 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 prone to be HIV good. With Cross River state given that 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 Rivers state (AOR: 7.37; 95% CI: 4•96–10.94) were more prone to be HIV positive. Education and sex that is transactional maybe perhaps not related to HIV among MSM in Nigeria.
This is the very first research to conduct a trend analysis of HIV prevalence as well as its correlates among MSM in Nigeria and now we identified a handful of important findings. First, HIV prevalence has steadily increased as time passes with a point that is 10-percentage on a yearly basis over 7 years. 2nd, the responsibility of HIV is greater among older MSM than more youthful people. Third, prevalence of STI in addition has increased throughout the full years and has now a lot more than doubled from 7per cent this season to 17per cent in 2014. 4th, although constant condom use has increased with transactional intercourse, the rise is less with non-transactional intercourse. Fifth, lower than 70% of MSM have actually ever been tested for HIV highlighting gaps that are major HIV avoidance intervention for MSM. Sixth, just about 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 had been very likely to be HIV positive. These findings straight mirror the continuing state of HIV development russian brides scam for MSM in Nigeria and methods, policies and programs must certanly be made 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. Nonetheless, within the third 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 general rise 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, when intercourse ended up being offered or purchased sufficient reason for non-transactional lovers. Nonetheless, while constant condom used in previous half a year significantly more than doubled when intercourse had been 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 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 the intercourse lovers, have already been utilized by MSM as prevention approaches 1, 35. Serosorting requires the choice of HIV-concordant intercourse lovers, while sero-positioning involves sex that is choosing centered on serostatus 1. A research in Seattle, U.S. A, revealed that among recently contaminated MSM, 69% reported UAI with HIV-positive or status that is unknown in contrast to 32% in HIV uninfected controls 4, 36. The Swiss HIV cohort research stated that the strongest predictor of UAI had been once you understand the HIV status of intimate partners with constant condom usage being 89% between stable discordant couples and 48% between HIV-infected lovers 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 practice is extensive given that familiarity with HIV status of partners remains restricted within companies.
The lower condom that is consistent in non-transactional intercourse may give an explanation for significant boost in self-reported STI between 2007 and 2014. Also, the type of who reported STIs, HIV prevalence increased between 2007 and 2014. Higher prevalence of STIs and undiagnosed HIV infections are markers of suboptimal usage of clinically competent and appropriate medical care services that are in change reported to reduce HIV-related health-seeking behavior in African MSM 1, 38. The access that is suboptimal medical and discrimination by medical workers are further worsened by the indegent money of MSM targeted avoidance and therapy solutions in Nigeria. Between 2007 and 2012, not as much as 5% of HIV money had been committed to most-at-risk populace much less than 5% focused on allowing environment for HIV programs 39,40,41.
The rise in constant condom usage observed during transactional intercourse might give an explanation for low sensed danger of HIV among MSM. Lower than a 3rd of MSM felt susceptible to HIV and because of the increased prevalence of HIV and STIs among MSM in Nigeria, efforts needs to be meant to increase HIV danger perception. The paradigm that is psychometric and 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 reported 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 as soon as the extent of a risk had been heightened, aside from the channel of interaction, there clearly was an associated positive and significant influence on intention and behaviour change 51. Behaviour modification interventions for HIV programs should really be made to increase the danger of HIV.