Only about a 3rd of participants (32%; 95% CI: 29–35%) felt these people 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 importance (p = 0•055). Self-reported past HIV test increased steadily from 34% (31–37%) in 2007 to 59percent (56–61%) this season and 65per cent (63–66%) in 2014. An evaluation associated with the recency for the HIV test indicated that over 70% stated that they received their HIV test within one year associated with research, with all the greatest tests that are recent 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 17% (15–19%) this season and 23% (22–34%) in 2014. Dining dining Table 2 shows HIV prevalence disaggregated by risk actions. Whenever analysis ended up being restricted to simply states that took part in the 3 rounds associated with the IBBSS (Cross River, Kano and Lagos) HIV prevalence ended up being 13% (11–16%) this season and 25per cent (22–27%) in 2014.
Those types of whom reported RAS just, HIV prevalence ended up being 19% (14–26%) in 2007, 23% (19–28%) this season and 24per cent (22–28%) in 2014. By generation, HIV prevalence had been 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.
When it comes to six states with information from at the least two rounds of IBBSS, there clearly was rise in HIV prevalence in four regarding the continuing 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 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% decline in HIV prevalence between 2010 and 2014.
Facets related to 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 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 those that involved in IAS only, people who involved 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 almost certainly going 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 streams state (AOR: 7.37; 95% CI: 4•96–10.94) were very likely to be HIV good. Education and sex that is transactional maybe perhaps not related to HIV among MSM in Nigeria.
Discussion
This is the very first research to conduct a trend analysis of HIV prevalence and its particular correlates among MSM in Nigeria so we identified a handful of important findings. First, HIV prevalence has steadily increased in the long run with a 10-percentage point enhance each year over 7 years. 2nd, the duty of HIV is higher among older MSM than younger people. Third, prevalence of STI in addition has increased on the years and it has significantly more than doubled from 7per cent this year to 17per cent in 2014. 4th, although constant condom usage has grown with transactional intercourse, the rise is less with non-transactional sex. 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, just about a third of MSM felt these were in danger for HIV and finally, in comparison to Cross River states, MSM who live in other states russian mail order brides pictures except Kano state had been more prone 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 first and 2nd rounds of IBBSS in 2007 through 2010, feminine intercourse workers (FSW) had shown the greatest prevalence of HIV among key populations in Nigeria. Nonetheless, 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 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 had been offered or purchased along with non-transactional lovers. Nonetheless, while constant condom used in previous half a year more than doubled whenever sex was sold, just 50% of the whom reported non-transactional intercourse utilized condoms consistently. This shows 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, have already been utilized by MSM as prevention approaches 1, 35. Serosorting involves the choice of HIV-concordant intercourse lovers, while sero-positioning involves sex that is choosing according to serostatus 1. A research in Seattle, U.S. A, revealed that among recently contaminated MSM, 69% reported UAI with HIV-positive or unknown status lovers in contrast to 32% in HIV uninfected settings 4, 36. The Swiss HIV cohort research stated that the strongest predictor 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 lovers 4, 37. The role of seroadapation in Nigeria is unknown and much more therefore with lower 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 sites.
The lower constant condom usage 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 behaviour in African MSM 1, 38. The access that is suboptimal health care and discrimination by medical workers are further worsened by the indegent financing of MSM targeted avoidance and therapy services in Nigeria. Between 2007 and 2012, lower than 5% of HIV money had been devoted to most-at-risk populace much less than 5% specialized in environment that is enabling 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. Not as much as a 3rd of MSM felt prone to HIV and because of the increased prevalence of HIV and STIs among MSM in Nigeria, efforts should be designed to increase HIV danger perception. The paradigm that is psychometric and many other social and health therapy theories 42,43,44,45,46,47,48,49 have identified risk perception as having a main role in determining behavior. A meta-analysis of risk 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 if the extent of the hazard ended up being heightened, aside from the channel of interaction, there is 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 risk of HIV.