High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria

Keshinro, Babajide; Crowell, Trevor A; Nowak, Rebecca G.; Adebajo, Sylvia; Peel, Sheila A.; Gaydos, Charlotte A.; Rodriguez‐Hart, Cristina; Baral, Stefan; Walsh, Melissa J; Njoku, O S; Odeyemi, Sunday; Ngo-Ndomb, Teclaire; Blattner, William A.; Robb, Merlin L.; Charurat, Manhattan; Ake, Julie A

doi:10.7448/ias.19.1.21270

Cited by 106 publications

(104 citation statements)

References 39 publications

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“…In Nigeria, not only is same‐sex sexual activity illegal, but the passage of the Same Sex Marriage (Prohibition) Act of 2013 has ushered in more violence against the LGBT community and has greatly restricted activities of nongovernmental organizations providing services to LGBT people, including any kind of health services. In Nigeria, the estimated HIV prevalence among MSM is 23% to 55% . Furthermore, only 65% of MSM have ever had an HIV test, and HIV testing rate during the past 12 months is less than 25% .…”

Section: Introductionmentioning

confidence: 99%

Uptake of HIV self‐testing and linkage to treatment among men who have sex with men (MSM) in Nigeria: A pilot programme using key opinion leaders to reach MSM

et al. 2018

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Introduction HIV self‐testing (HIVST) offers an alternative to facility‐based HIV testing services, particularly for populations such as men who have sex with men (MSM) who may fear accessing testing due to stigma, discrimination and criminalization. Innovative HIV testing approaches are needed to meet the goal of 90% of people living with HIV being diagnosed. This study piloted an intervention to distribute oral HIVST kits to MSM through key opinion leaders (KOLs) in Lagos, Nigeria and assessed the feasibility, acceptability, uptake of HIVST and linkage to HIV treatment.MethodsA cohort study was conducted (May through September 2017) with 319 participants who were recruited by 12 KOLs through their networks. A baseline survey was conducted at the time of the oral HIVST kit (OraQuick® HIV antibody test) distribution to eligible MSM followed by a 3‐month follow‐up survey to assess usage of and experience with the HIVST kits. Each participant was given two kits.ResultsThe median age of the participants was 25 years, 88.7% were literate and 17.9% were first‐time testers. Of the 257 participants (80.7% retention) who completed the three‐month follow‐up interview, 97.7% reported using the HIVST kit and 14 (5.6%) self‐reported an HIV positive result. A quarter (22.7%) tested themselves the same day they received the kit, and 49.4% tested within one week. Almost all participants reported that the HIVST kit instructions were easy or somewhat easy to understand (99.6%) and perform the test (98.0%). The most common reasons they liked the test were ease of use (87.3%), confidentiality/privacy (82.1%), convenience (74.1%) and absence of needle pricks (64.9%). All 14 participants who tested positive had sought confirmatory testing and initiated HIV treatment by the time of the three‐month survey.ConclusionsHIVST distribution through KOLs was feasible and oral self‐testing was highly acceptable among this urban MSM population. Despite concerns about linkage to treatment when implementing self‐testing, this study showed that linkage to treatment can be achieved with active follow‐up and access to a trusted MSM‐friendly community clinic that offers HIV treatment. HIVST should be considered as an additional option to standard HIV testing models for MSM.

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Section: Introductionmentioning

confidence: 99%

Uptake of HIV self‐testing and linkage to treatment among men who have sex with men (MSM) in Nigeria: A pilot programme using key opinion leaders to reach MSM

et al. 2018

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“…For this reason, it remains challenging to effectively engage MSM living with HIV in Nigeria given that they are less likely to access health care services and are at risk of uncontrolled viral load. MSM are disproportionately affected by HIV with prevalence of HIV among Nigerian MSM ranging from 44% to 66 % compared to 3.2% in general population 13,14 . Similarly, incidence and prevalence of sexually transmitted infections (STI) among Nigerian MSM are high 13,15 , posing the risk of adverse clinical outcomes and also onward HIV transmission.…”

Section: Introductionmentioning

confidence: 99%

“…MSM are disproportionately affected by HIV with prevalence of HIV among Nigerian MSM ranging from 44% to 66 % compared to 3.2% in general population 13,14 . Similarly, incidence and prevalence of sexually transmitted infections (STI) among Nigerian MSM are high 13,15 , posing the risk of adverse clinical outcomes and also onward HIV transmission. Understanding the multi-level barriers and enhancers is key to designing and implementing more effective treatment and prevention programs.…”

Section: Introductionmentioning

confidence: 99%

Individual and Network Factors Associated With HIV Care Continuum Outcomes Among Nigerian MSM Accessing Health Care Services

Ramadhani

Ndembi

Nowak

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background and setting As data on the determinants of the HIV care continuum from key populations such as men who have sex with men (MSM) in resource-limited, settings (RLS) are limited, the study aimed to characterize HIV care continuum outcomes and assess individual and network barriers to progression through the HIV care continuum among MSM in Abuja and Lagos, Nigeria. Methods TRUST/RV368 study used respondent-driven-sampling to accrue MSM into community-based clinics in Nigeria. Participants received HIV testing at enrollment. HIV-infected participants were offered antiretroviral therapy (ART) with HIV RNA testing every three months (Abuja) or six months (Lagos). Multiple logistic regression models were used to calculate adjusted odds ratios for factors associated with each point in the HIV care continuum, including HIV testing, ART initiation, and six-month viral suppression. Results A total of 1506 MSM were recruited, 1178 (78.2%) tested for HIV and 369 (31.3%) were HIV positive newly diagnosed. Of these, 188 (50.1%) initiated ART, 136 (72.3%) completed six months and 96 (70.6%) were virally suppressed. Larger network size and stronger social network support were positively associated with HIV testing uptake. Factors associated with ART initiation were higher education and stronger social network support. Having stronger social network support was associated with increased odds of viral suppression at six months. Conclusions Social determinants of health potentiated increased HIV Care Continuum outcomes. Integration of HIV prevention, HIV Counselling and Testing services and universal coverage of ART into a community-based clinic is critical in achieving better hig HIV Care Continuum outcomes.

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“…In the face of competing socio-economic demands and poor health seeking behaviors such clients easily deprioritize their health needs in favour of basic needs like food, clothing and internet connectivity. In order to address this challenge, most studies [27] [28] [29] [30] [31] provide transportation refund/incentive to study participants. While this may be justified as compensation for participation in a study, most donors will not accommodate incentive for clients in service delivery implementation.…”

Section: Discussionmentioning

confidence: 99%

HIV Treatment Cascade Assessment of a Community-Based Test and Start Model for Key Populations in Lagos State Nigeria: Where Are the Gaps?

Njab¹,

Adebajo²,

Eluwa³

et al. 2018

WJA

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Background: Community-based test and start (TAS) models have shown the potential to improve clinical outcomes for key populations because early access to treatment will have population level impact by reducing transmission through the promotion and provision of hassle-free quality HIV testing, on the spot ART initiation and unrestricted access to culturally competent health professionals. We assessed the effectiveness of a pioneer community-based test and start (TAS) model for key populations in Lagos along UNAIDS 90/90/90 cascade. Methods: Men who have sex with men (MSM), female sex workers (FSW), and persons who inject drugs (PWID), >14 years of age were recruited through peer-referral for HIV testing services (HTS) at a community-based KP-friendly clinic in Lagos between June 2015 and September 2016. The clinic provides comprehensive HIV services, including HIV treatment. Those who test positive are enrolled and provided with TAS services. Using routine service data, we deployed descriptive cross tabulations at p < 5% to determine the performance along the 90/90/90 cascade. Results: In total, 8812 KPs comprising MSM (51.6%), FSW (32.7%) and PWID (15.7%) were tested during this period. About one-half (46.4%) were young KP (15-25 years). The majority (76.1%) were male, single (86.1%), almost all (99%) had at least primary school level education, and about one-quarter (25.1%) were employed. Among MSM, 506 (11.1%) tested positive, 276 (54.5%) were initiated on ART, of whom 155 conducted viral load testing and 88 (56.7%) had achieved viral suppression (<1000 copies per milliliter). Among FSW, 88 (3.1%) tested positive, only 28 (31.8%) were initiated on ART, of whom 15 conducted viral load testing and 9 (60%) achieved viral suppression. Among PWID, of 15 (1.1%) who tested positive, only 2 (13%) were initiated on ART

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High prevalence of HIV, chlamydia and gonorrhoea among men who have sex with men and transgender women attending trusted community centres in Abuja and Lagos, Nigeria

Cited by 106 publications

References 39 publications

Uptake of HIV self‐testing and linkage to treatment among men who have sex with men (MSM) in Nigeria: A pilot programme using key opinion leaders to reach MSM

Uptake of HIV self‐testing and linkage to treatment among men who have sex with men (MSM) in Nigeria: A pilot programme using key opinion leaders to reach MSM

Individual and Network Factors Associated With HIV Care Continuum Outcomes Among Nigerian MSM Accessing Health Care Services

HIV Treatment Cascade Assessment of a Community-Based Test and Start Model for Key Populations in Lagos State Nigeria: Where Are the Gaps?

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