BMC Public Health | |
Correlates of prior HIV testing among men who have sex with men in Cameroon: a cross-sectional analysis | |
Stefan Baral8  Sosthenes Charles Ketende8  Matthew LeBreton6  Jules Eloundou3  Valentin Mondoleba5  Yves Roger Yomb7  Isaac Macauley4  Laure Moukam1  Ashley Grosso8  Sethson Kassegne2  Jean Bosco Elat5  Serge Clotaire Billong5  Erin Papworth8  Ju Nyeong Park8  | |
[1] Association Camerounaise pour le Marketing Social (ACMS), Yaoundé, Cameroon;West and Central Africa region, Population Services International, Cotonou, Bénin;Humanity First, Yaoundé, Cameroon;CARE International Cameroon, Yaoundé, Cameroon;Comité national de lutte contre le sida (CNLS), Ministère de la Sante Publique (MINSANTE), Yaoundé, Cameroon;Mosaic/Global Viral Cameroon, Yaoundé, Cameroon;Alternatives-Cameroun, Douala, Cameroon;Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA | |
关键词: Health behaviors; Risk factors; Prevention; Homosexuality; Respondent-driven sampling (RDS); Africa; Epidemiology; Voluntary counseling and testing (VCT); HIV testing; HIV/AIDS; Men who have sex with men (MSM); | |
Others : 1122893 DOI : 10.1186/1471-2458-14-1220 |
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received in 2014-06-12, accepted in 2014-11-10, 发布年份 2014 | |
【 摘 要 】
Background
Regular HIV testing is vital for timely linkage to the HIV care continuum and ensuring the success of behavioral and biomedical interventions to prevent HIV acquisition. Men who have sex with men (MSM) are a key population for HIV prevention, treatment, and care efforts globally. This study measures the factors associated with prior HIV testing among MSM in Cameroon.
Methods
In 2011, 272 and 239 MSM aged ≥ 18 were recruited from Douala and Yaoundé respectively using respondent-driven sampling (RDS) for a cross-sectional surveillance study. Participants completed a structured socio-behavioral survey and were offered HIV and syphilis testing and counseling.
Results
The majority of men self-reported ever testing for HIV (81.6%; 413/506) and receiving their last HIV test result (95.4%; 394/413). Testing in the last 12 months was more prevalent in Douala (63.3%; 169/267) compared to Yaoundé (55.9%; 132/236). Median frequency of testing was every 18 months in Douala and every two years in Yaoundé. In multivariate RDS-weighted analysis, correlates of ever testing for HIV in Douala were: having higher than secondary education compared to having secondary education or less (aOR = 3.51, 95% CI: 1.32-9.34), ever accessing a community-based HIV service for MSM (aOR = 3.37, 95% CI: 1.57-7.24) and having ≥4 male oral or anal sexual partners in the past 12 months (aOR = 2.49, 1.08-5.74). In Yaoundé, having higher than secondary education (aOR = 7.96, 95% CI: 1.31-48.41) was associated with ever testing for HIV.
Conclusions
Supporting regular HIV testing and linkage to care is important in a context of high HIV prevalence and limited use of condoms and condom-compatible lubricants. Building the capacity of MSM organizations and mainstream health services to deliver affordable, integrated, confidential, and MSM-sensitive HIV testing may assist in effectively engaging more MSM in the HIV treatment cascade. Giving specific attention to MSM who are younger, of lower socioeconomic status and less connected to community-based MSM organizations may increase HIV testing uptake. Given the levels of HIV testing and high HIV prevalence among MSM in Cameroon, optimizing the safe and effective provision and uptake of antiretroviral-based prevention and treatment approaches is paramount in changing the trajectory of the HIV epidemic among these men and within their sexual networks.
【 授权许可】
2014 Park et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150215023704443.pdf | 352KB | download | |
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【 图 表 】
Figure 1.
【 参考文献 】
- [1]Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, Brookmeyer R: Global epidemiology of HIV infection in men who have sex with men. Lancet 2012, 380:367-377.
- [2]Baral S, Sifakis F, Cleghorn F, Beyrer C: Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000–2006: a systematic review. PLoS Med 2007, 4:e339.
- [3]van Griensven F, de Lind Van Wijngaarden JW, Baral S, Grulich A: The global epidemic of HIV infection among men who have sex with men. Curr Opin HIV AIDS 2009, 4:300-307.
- [4]Papworth E, Ceesay N, An L, Thiam-Niangoin M, Ky-Zerbo O, Holland C, Drame FM, Grosso A, Diouf D, Baral SD: Epidemiology of HIV among female sex workers, their clients, men who have sex with men and people who inject drugs in West and Central Africa. J Int AIDS Soc 2013, 16:18751.
- [5]Park JN, Papworth E, Kassegne S, Moukam L, Billong SC, Macauley I, Yomb YR, Nkoume N, Mondoleba V, Eloundou J, LeBreton M, Tamoufe U, Grosso A, Baral SD: HIV prevalence and factors associated with HIV infection among men who have sex with men in Cameroon. J Int AIDS Soc 2013, 16:18752.
- [6]Marks G, Crepaz N, Senterfitt JW, Janssen RS: Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr 2005, 39:446-453.
- [7]Baral S, Trapence G, Motimedi F, Umar E, Iipinge S, Dausab F, Beyrer C: HIV prevalence, risks for HIV infection, and human rights among men who have sex with men (MSM) in Malawi, Namibia, and Botswana. PLoS One 2009, 4:e4997.
- [8]Nel JA, Yi H, Sandfort TG, Rich E: HIV-untested men who have sex with men in South Africa: the perception of not being at risk and fear of being tested. AIDS Behav 2013, 17 Suppl 1:S51-S59.
- [9]Lane T, Raymond HF, Dladla S, Rasethe J, Struthers H, McFarland W, McIntyre J: High HIV prevalence among men who have sex with men in Soweto, South Africa: results from the Soweto Men’s Study. AIDS Behav 2011, 15:626-634.
- [10]Baral SD, Ketende S, Mnisi Z, Mabuza X, Grosso A, Sithole B, Maziya S, Kerrigan DL, Green JL, Kennedy CE, Adams D: A cross-sectional assessment of the burden of HIV and associated individual- and structural-level characteristics among men who have sex with men in Swaziland. J Int AIDS Soc 2013, 16:18768.
- [11]Batist E, Brown B, Scheibe A, Baral SD, Bekker LG: Outcomes of a community-based HIV-prevention pilot programme for township men who have sex with men in Cape Town, South Africa. J Int AIDS Soc 2013, 16:18754.
- [12]Baral S, Adams D, Lebona J, Kaibe B, Letsie P, Tshehlo R, Wirtz A, Beyrer C: A cross-sectional assessment of population demographics. HIV risks and human rights contexts among men who have sex with men in Lesotho. J Int AIDS Soc 2011, 14:36. BioMed Central Full Text
- [13]Wade AS, Kane CT, Diallo PA, Diop AK, Gueye K, Mboup S, Ndoye I, Lagarde E: HIV infection and sexually transmitted infections among men who have sex with men in Senegal. AIDS 2005, 19:2133-2140.
- [14]Dramé FM, Crawford EE, Diouf D, Beyrer C, Baral SD: A pilot cohort study to assess the feasibility of HIV prevention science research among men who have sex with men in Dakar, Senegal. J Int AIDS Soc 2013, 16(Suppl 3):18753.
- [15]Vu L, Andrinopoulos K, Tun W, Adebajo S: High levels of unprotected anal intercourse and never testing for HIV among men who have sex with men in Nigeria: evidence from a cross-sectional survey for the need for innovative approaches to HIV prevention. Sex Transm Infect 2013, 89:659-665.
- [16]Merrigan M, Azeez A, Afolabi B, Chabikuli ON, Onyekwena O, Eluwa G, Aiyenigba B, Kawu I, Ogungbemi K, Hamelmann C: HIV prevalence and risk behaviours among men having sex with men in Nigeria. Sex Transm Infect 2011, 87:65-70.
- [17]Lorente N, Henry E, Fugon L, Yomb Y, Carrieri MP, Eboko F, Spire B: Proximity to HIV is associated with a high rate of HIV testing among men who have sex with men living in Douala, Cameroon. AIDS Care 2012, 24:1020-1027.
- [18]Finlayson TJ, Le B, Smith A, Bowles K, Cribbin M, Miles I, Oster AM, Martin T, Edwards A, Dinenno E: HIV risk, prevention, and testing behaviors among men who have sex with men–National HIV Behavioral Surveillance System, 21 U.S. cities, United States, 2008. MMWR Surveill Summ 2011, 60:1-34.
- [19]Beyrer C, Trapence G, Motimedi F, Umar E, Iipinge S, Dausab F, Baral S: Bisexual concurrency, bisexual partnerships, and HIV among Southern African men who have sex with men. Sex Transm Infect 2010, 86:323-327.
- [20]Sandfort TG, Nel J, Rich E, Reddy V, Yi H: HIV testing and self-reported HIV status in South African men who have sex with men: results from a community-based survey. Sex Transm Infect 2008, 84:425-429.
- [21]Knox J, Sandfort T, Yi H, Reddy V, Maimane S: Social vulnerability and HIV testing among South African men who have sex with men. Int J STD AIDS 2011, 22:709-713.
- [22]Geibel S, Tun W, Tapsoba P, Kellerman S: HIV vulnerability of men who have sex with men in developing countries: Horizons studies, 2001–2008. Public Health Rep 2010, 125:316-324.
- [23]Kalamar M, Maharaj P, Gresh A: HIV-prevention interventions targeting men having sex with men in Africa: field experiences from Cameroon. Cult Health Sex 2011, 13:1135-1149.
- [24]Altman D, Aggleton P, Williams M, Kong T, Reddy V, Harrad D, Reis T, Parker R: Men who have sex with men: stigma and discrimination. Lancet 2012, 380:439-445.
- [25]Human Rights Watch: Criminalizing Identities: Rights abuses in Cameroon based on sexual Orientation and gender identity. In Book Criminalizing Identities: Rights abuses in Cameroon based on sexual Orientation and gender identity. New York, NY: Human Rights Watch; 2010.
- [26]Fay H, Baral SD, Trapence G, Motimedi F, Umar E, Iipinge S, Dausab F, Wirtz A, Beyrer C: Stigma, health care access, and HIV knowledge among men who have sex with men in Malawi, Namibia, and Botswana. AIDS Behav 2011, 15:1088-1097.
- [27]Poteat T, Diouf D, Drame FM, Ndaw M, Traore C, Dhaliwal M, Beyrer C, Baral S: HIV risk among MSM in Senegal: a qualitative rapid assessment of the impact of enforcing laws that criminalize same sex practices. PLoS One 2011, 6:e28760.
- [28]Rispel LC, Metcalf CA, Cloete A, Moorman J, Reddy V: You become afraid to tell them that you are gay: health service utilization by men who have sex with men in South African cities. J Public Health Policy 2011, 32(Suppl 1):S137-S151.
- [29]Spielberg F, Branson BM, Goldbaum GM, Lockhart D, Kurth A, Celum CL, Rossini A, Critchlow CW, Wood RW: Overcoming barriers to HIV testing: preferences for new strategies among clients of a needle exchange, a sexually transmitted disease clinic, and sex venues for men who have sex with men. J Acquir Immune Defic Syndr 2003, 32:318-327.
- [30]Levy ME, Wilton L, Phillips G 2nd, Glick SN, Kuo I, Brewer RA, Elliott A, Watson C, Magnus M: Understanding Structural Barriers to Accessing HIV Testing and Prevention Services Among Black Men Who Have Sex with Men (BMSM) in the United States. AIDS Behav 2014, 18:972-996.
- [31]Yasin F, Delegchoimbol A, Jamiyanjamts N, Sovd T, Mason K, Baral S: A Cross-Sectional Evaluation of Correlates of HIV Testing Practices Among Men Who Have Sex with Men (MSM) in Mongolia. AIDS Behav 2013, 17:1378-1385.
- [32]Millett GA, Jeffries WL, Peterson JL, Malebranche DJ, Lane T, Flores SA, Fenton KA, Wilson PA, Steiner R, Heilig CM: Common roots: a contextual review of HIV epidemics in black men who have sex with men across the African diaspora. Lancet 2012, 380:411-423.
- [33]Beyrer C, Sullivan PS, Sanchez J, Dowdy D, Altman D, Trapence G, Collins C, Katabira E, Kazatchkine M, Sidibe M, Mayer KH: A call to action for comprehensive HIV services for men who have sex with men. Lancet 2012, 380:424-438.
- [34]Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C: Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health 2013, 13:482. BioMed Central Full Text
- [35]National AIDS Control Commitee: UNGASS Coutry Progress Report: Rapport national de suivi de la declaration politique sur le VIH/SIDA Cameroun. In Book UNGASS Coutry Progress Report: Rapport national de suivi de la declaration politique sur le VIH/SIDA Cameroun. Yaoundé, Cameroon: Joint United Nations Programme on HIV/AIDS; 2012.
- [36]Heckathorn DD: Respondent-driven sampling: A new approach to the study of hidden populations. Soc Probl 1997, 44:174-199.
- [37]Volz E, Heckathorn DD: Probability Based Estimation Theory for Respondent Driven Sampling. J Off Stat 2008, 24:79-97.
- [38]Centers for Disease Control and Prevention: HIV testing among men who have sex with men--21 cities, United States, 2008. MMWR Morb Mortal Wkly Rep 2011, 60:694-699.
- [39]Mah TL, Halperin DT: Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS Behav 2010, 14:11-16. dicussion 34–17
- [40]Sandoy IF, Dzekedzeke K, Fylkesnes K: Prevalence and correlates of concurrent sexual partnerships in Zambia. AIDS Behav 2010, 14:59-71.
- [41]Das M, Chu PL, Santos GM, Scheer S, Vittinghoff E, McFarland W, Colfax GN: Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS One 2010, 5:e11068.
- [42]Mayer KH, Pape JW, Wilson P, Diallo DD, Saavedra J, Mimiaga MJ, Koenig S, Farmer P: Multiple determinants, common vulnerabilities, and creative responses: addressing the AIDS pandemic in diverse populations globally. J Acquir Immune Defic Syndr 2012, 60(Suppl 2):S31-S34.
- [43]Henley C, Forgwei G, Welty T, Golden M, Adimora A, Shields R, Muffih PT: Scale-up and case-finding effectiveness of an HIV partner services program in Cameroon: an innovative HIV prevention intervention for developing countries. Sex Transm Dis 2013, 40:909-914.
- [44]Beyrer C, Wirtz AL, Walker D, Johns B, Sifakis F, Baral SD: Scenario 3 Country Studies: Kenya, Malawi, and Senegal. In The Global HIV Epidemics among Men who have Sex with Men. Washington DC: The World Bank; 2011:81-110.
- [45]van der Elst EM, Smith AD, Gichuru E, Wahome E, Musyoki H, Muraguri N, Fegan G, Duby Z, Bekker LG, Bender B, Graham SM, Operario D, Sanders EJ: Men who have sex with men sensitivity training reduces homoprejudice and increases knowledge among Kenyan healthcare providers in coastal Kenya. J Int AIDS Soc 2013, 16:18748.
- [46]van der Elst EM, Gichuru E, Omar A, Kanungi J, Duby Z, Midoun M, Shangani S, Graham SM, Smith AD, Sanders EJ, Operario D: Experiences of Kenyan healthcare workers providing services to men who have sex with men: qualitative findings from a sensitivity training programme. J Int AIDS Soc 2013, 16:18741.
- [47]International Lesbian Gay Bisexual Trans and Intersex Association: State Sponsored Homophobia report 2011: A World Survey of Laws Criminalising Same-Sex Sexual Acts between Consenting Adults. Geneva, Switzerland: International Lesbian, Gay, Bisexual, Trans and Intersex Association; 2012.
- [48]Betron M, Gonzalez-Figueroa E: Gender Identity, Violence, and HIV among MSM and TG: A Literature Review and a Call for Screening. Washington D.C.: Futures Group International, USAID. Health Policy Initiative, Task Order 1; 2009.
- [49]Pant Pai N, Sharma J, Shivkumar S, Pillay S, Vadnais C, Joseph L, Dheda K, Peeling RW: Supervised and unsupervised self-testing for HIV in high- and low-risk populations: a systematic review. PLoS Med 2013, 10:e1001414.
- [50]MacKellar DA, Valleroy LA, Secura GM, Bartholow BN, McFarland W, Shehan D, Ford W, LaLota M, Celentano DD, Koblin BA, Torian LV, Perdue TE, Janssen RS, Young Men's Survey Study, Group: Repeat HIV testing, risk behaviors, and HIV seroconversion among young men who have sex with men: a call to monitor and improve the practice of prevention. J Acquir Immune Defic Syndr 2002, 29:76-85.
- [51]Grosso A: Social support as a predictor of HIV testing in at-risk populations: a research note. J Health Hum Serv Adm 2010, 33:53-62.
- [52]Centers for Disease Control and Prevention: Vital signs: HIV prevention through care and treatment--United States. MMWR Morb Mortal Wkly Rep 2011, 60:1618-1623.
- [53]Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ: The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis 2011, 52:793-800.