HIV among men who have sex with men in Malawi: elucidating HIV prevalence and correlates of infection to inform HIV prevention

• DOI: 10.7448/ias.16.4.18742
• Publication Date: 2013-12-02T15:27:46Z
• Authors: Andrea L Wirtz; Vincent Jumbe; Gift Trapence; Dunker Kamba; Eric Umar; Sosthenes Ketende; Mark Berry; Susanne Strömdahl; Chris Beyrer; Stefan D Baral
• Keywords: Marital status

Introduction There are limited data characterizing the burden of HIV among men who have sex with (MSM) in Malawi. Epidemiologic research and access to prevention, treatment care services been traditionally Malawi by criminalization stigmatization same‐sex practices. To inform development a comprehensive prevention intervention for Malawian MSM, we conducted community‐led assessment prevalence correlates infection. Methods From April 2011 March 2012, 338 MSM were enrolled cross‐sectional study Blantyre, Participants recruited respondent‐driven sampling methods (RDS), reaching 19 waves. Trained staff administered socio‐behavioural survey syphilis voluntary counselling testing. Results Crude estimates 15.4% (RDS‐weighted 12.5%, 95% confidence interval (CI): 7.3–17.8) 5.3% 4.4%, CI: 3.1–7.6), respectively. Ninety per cent (90.4%, unweighted) infections reported as being previously undiagnosed. predominantly gay‐identified (60.8%) or bisexually identified (36.3%); 50.7% recent concurrent relationships. Approximately half consistent condom use (always almost always) casual male partners, proportions relatively uniform across partner types genders. The perceived experienced stigma exceeded 20% all variables, 11.4% ever physical violence 7% raped. Current age >25 years adjusted odds ratio (AOR) 3.9, 1.2–12.7), single marital status AOR: 0.3; 0.1–0.8) first man <16 4.3, 1.2–15.0) independently associated Conclusions demonstrate that represent an underserved, at‐risk population merit services. provide number priorities programmes including providing encouraging regular confidential testing counselling, risk reduction related anal intercourse. Other targets include provision condoms compatible lubricants, information, sexually transmitted infection adherence support. Addressing multiple levels risk, structural factors, may help ensure sufficient coverage impact this epidemic MSM.