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HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa
BACKGROUND: The HIV epidemic in Sub Saharan Africa has been traditionally assumed to be driven by high risk heterosexual and vertical transmission. However, there is an increasing body of data highlighting the disproportionate burden of HIV infection among MSM in the generalized HIV epidemics across...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3196714/ https://www.ncbi.nlm.nih.gov/pubmed/21975248 http://dx.doi.org/10.1186/1471-2458-11-766 |
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author | Baral, Stefan Burrell, Earl Scheibe, Andrew Brown, Ben Beyrer, Chris Bekker, Linda-Gail |
author_facet | Baral, Stefan Burrell, Earl Scheibe, Andrew Brown, Ben Beyrer, Chris Bekker, Linda-Gail |
author_sort | Baral, Stefan |
collection | PubMed |
description | BACKGROUND: The HIV epidemic in Sub Saharan Africa has been traditionally assumed to be driven by high risk heterosexual and vertical transmission. However, there is an increasing body of data highlighting the disproportionate burden of HIV infection among MSM in the generalized HIV epidemics across of Southern Africa. In South Africa specifically, there has been an increase in attention focused on the risk status and preventive needs of MSM both in urban centers and peri-urban townships. The study presented here represents the first evaluation of HIV prevalence and associations of HIV infection among MSM in the peri-urban townships of Cape Town. METHODS: The study consisted of an anonymous probe of 200 men, reporting ever having had sex with another man, recruited through venue-base sampling from January to February, 2009. RESULTS: Overall, HIV prevalence was 25.5% (n = 51/200). Of these prevalent HIV infections, only 6% of HIV-1 infected MSM were aware of their HIV status (3/50). 0% of men reported always having safe sex as defined by always wearing condoms during sex and using water-based lubricants. Independent associations with HIV infection included inconsistent condom use with male partners (aOR 2.3, 95% CI 1.0-5.4), having been blackmailed (aOR 4.4, 95% CI 1.6-20.2), age over 26 years (aOR 4.2, 95% CI 1.6-10.6), being unemployed (aOR 3.7, 95% CI 1.5-9.3), and rural origin (aOR 6.0, 95% CI 2.2-16.7). Bisexual activity was reported by 17.1% (34/199), and a total of 8% (16/200) reported having a regular female partner. Human rights violations were common with 10.5% (n = 21/200) reporting having been blackmailed and 21.0% (n = 42/200) reporting being afraid to seek health care. CONCLUSIONS: The conclusions from this study include that a there is a high risk and underserved population of MSM in the townships surrounding Cape Town. The high HIV prevalence and high risk sexual practices suggest that prevalence will continue to increase among these men in the context of an otherwise slowing epidemic. These data further highlight the need to better characterize risk factors for HIV prevention and appropriate targeted combination packages of HIV interventions including biomedical, behavioural, and structural approaches to mitigate HIV risk among these men. |
format | Online Article Text |
id | pubmed-3196714 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31967142011-10-20 HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa Baral, Stefan Burrell, Earl Scheibe, Andrew Brown, Ben Beyrer, Chris Bekker, Linda-Gail BMC Public Health Research Article BACKGROUND: The HIV epidemic in Sub Saharan Africa has been traditionally assumed to be driven by high risk heterosexual and vertical transmission. However, there is an increasing body of data highlighting the disproportionate burden of HIV infection among MSM in the generalized HIV epidemics across of Southern Africa. In South Africa specifically, there has been an increase in attention focused on the risk status and preventive needs of MSM both in urban centers and peri-urban townships. The study presented here represents the first evaluation of HIV prevalence and associations of HIV infection among MSM in the peri-urban townships of Cape Town. METHODS: The study consisted of an anonymous probe of 200 men, reporting ever having had sex with another man, recruited through venue-base sampling from January to February, 2009. RESULTS: Overall, HIV prevalence was 25.5% (n = 51/200). Of these prevalent HIV infections, only 6% of HIV-1 infected MSM were aware of their HIV status (3/50). 0% of men reported always having safe sex as defined by always wearing condoms during sex and using water-based lubricants. Independent associations with HIV infection included inconsistent condom use with male partners (aOR 2.3, 95% CI 1.0-5.4), having been blackmailed (aOR 4.4, 95% CI 1.6-20.2), age over 26 years (aOR 4.2, 95% CI 1.6-10.6), being unemployed (aOR 3.7, 95% CI 1.5-9.3), and rural origin (aOR 6.0, 95% CI 2.2-16.7). Bisexual activity was reported by 17.1% (34/199), and a total of 8% (16/200) reported having a regular female partner. Human rights violations were common with 10.5% (n = 21/200) reporting having been blackmailed and 21.0% (n = 42/200) reporting being afraid to seek health care. CONCLUSIONS: The conclusions from this study include that a there is a high risk and underserved population of MSM in the townships surrounding Cape Town. The high HIV prevalence and high risk sexual practices suggest that prevalence will continue to increase among these men in the context of an otherwise slowing epidemic. These data further highlight the need to better characterize risk factors for HIV prevention and appropriate targeted combination packages of HIV interventions including biomedical, behavioural, and structural approaches to mitigate HIV risk among these men. BioMed Central 2011-10-05 /pmc/articles/PMC3196714/ /pubmed/21975248 http://dx.doi.org/10.1186/1471-2458-11-766 Text en Copyright ©2011 Baral et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Baral, Stefan Burrell, Earl Scheibe, Andrew Brown, Ben Beyrer, Chris Bekker, Linda-Gail HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa |
title | HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa |
title_full | HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa |
title_fullStr | HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa |
title_full_unstemmed | HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa |
title_short | HIV Risk and Associations of HIV Infection among men who have sex with men in Peri-Urban Cape Town, South Africa |
title_sort | hiv risk and associations of hiv infection among men who have sex with men in peri-urban cape town, south africa |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3196714/ https://www.ncbi.nlm.nih.gov/pubmed/21975248 http://dx.doi.org/10.1186/1471-2458-11-766 |
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