Subject(s)
Emergency Nursing , Hotlines , Job Satisfaction , Telenursing , Humans , International AgenciesABSTRACT
We conducted a respondent driven sampling survey to estimate HIV prevalence and risk behavior among men who have sex with men (MSM) in Unguja, Zanzibar. Men aged ≥ 15 years living in Unguja and reporting anal sex with another man in the past 3 months were asked to complete a questionnaire and provide specimens for biologic testing. HIV prevalence was 12.3% (95% confidence interval 8.7, 16.3). HIV infection was associated with injecting drugs in the past 3 months, Hepatitis C virus infection and being paid for sex in the past year. Interventions for MSM in Zanzibar are needed and should include linkages to prevention, care and treatment services.
Subject(s)
HIV Infections/epidemiology , Hepatitis C/epidemiology , Homosexuality, Male/psychology , Risk-Taking , Adult , Cross-Sectional Studies , HIV Infections/diagnosis , HIV Infections/transmission , HIV Seropositivity/epidemiology , Health Surveys , Hepatitis C/diagnosis , Homosexuality, Male/statistics & numerical data , Humans , Male , Middle Aged , Population Surveillance , Prevalence , Risk Factors , Self Report , Socioeconomic Factors , Substance Abuse, Intravenous/epidemiology , Surveys and Questionnaires , Tanzania , Unsafe Sex/statistics & numerical data , Young AdultABSTRACT
BACKGROUND: Men who have sex with men and inject drugs (MSM-IDU) are particularly vulnerable to HIV infection and have the potential to transmit HIV across multiple populations through their male and female sexual partners and injection drug-using partners. METHODS: Respondent-driven sampling was used to recruit men who reported engaging in anal sex with another man in the past 3 months, aged ≥15 years, and living in Unguja, Zanzibar. Participants responded to a face-to-face interview about their HIV and injecting risk behaviours and were tested for HIV, Hepatitis B (HBV) and C (HCV) and syphilis. RESULTS: Among the 509 MSM who enrolled in the survey, 14% (n=66) reported injecting drugs in the past 3 months among which 66% used heroin, 60% used a needle after someone else had and 68% passed a needle to someone else after using it. MSM-IDU were significantly more likely to have two or more non-paying male receptive sex partners and to have engaged in group sex in the past month, to have symptoms of a sexually transmitted infection in past 6 months, to have been arrested or beaten in the past 12 months and to be infected with HIV and co-infected with HIV and HCV compared to MSM who did not inject drugs. MSM-IDU were less likely to have used a condom at last sex with a non-paid female partner, to know where to get a confidential HIV test and to have ever been tested for HIV compared to MSM who did not inject drugs. CONCLUSION: MSM-IDU, and MSM in general, in Unguja practice multiple high-risk behaviours that put them at risk for blood-borne and sexual transmission of HIV and HCV infection. Targeted interventions for MSM-IDU must account for the overlap of high-risk sexual and drug-using networks and integrate injection drug use and HIV services.
