Hiv Prevalence and Associated Risk Factors Among Men Who Have Sex With Men in Dar Es Salaam, Tanzania

Abstract

Introduction: Limited studies and differential risk behaviours among men who have sex with men (MSM) in Africa calls for population specific studies. We present results from the largest integrated bio-behavioural survey among MSM in Africa to inform programming. Methods: This was a cross-sectional study utilizing respondent driven sampling to recruit MSM aged 18 and above. Data on socio-demographic characteristics and HIV-related risks were collected and all participants were tested for HIV, Herpes Simplex Virus Type-2 (HSV2), Hepatitis-B Virus (HBV) and Syphilis. Results: A total of 753 MSM with a mean age of 26.5 years participated in the study and 646 (85.7%) gave blood for biological testing. The prevalence of HIV was 22.3%, HSV-2 40.9%, syphilis 1.1 %, and HBV 3.25%. Significant risk factors for HIV were age above 25, having no children (aOR), 2.4, 95% CI: 1.4-4.2), low HIV-risk perception (aOR, 2.6, 95% CI: 1.2- 5.3), receptive position (aOR, 8.7; 95% CI 1.2-5.3), and not using water-based lubricants (aOR, 2.6, 95% CI: 1.0-4.5) during last anal sex. Also associated with HIV infection was, having sexual relationships with women (aOR, 8.0, 95% CI: 4.1-15.6), engaging in group sex (aOR, 3.8, 95% CI: 1.6-8.4), HSV-2 seropositivity (aOR, 4.1, 95% CI: 2.6- 6.5) and history of genital ulcers (aOR, 4.1, 95% CI: 1.1-7.2). Conclusions: HIV infection and HSV-2 were highly prevalent among MSM. Low perceived HIV risk, practice of risk behaviours and infection with HSV-2 were significant predictors of HIV infection. Behavioural interventions, HSV-2 suppressive therapies and Pre-exposure Prophylaxis are highly needed. The final version of this research has been published in Journal of Acquired Immune Deficiency Syndromes. © 2018 Lippincott, Williams & Wilkins