Sex Transm Infect 86:136-140 doi:10.1136/sti.2009.036939
  • Behaviour

Factors associated with unprotected anal intercourse among men who have sex with men in Douala, Cameroon

Editor's Choice
  1. B Spire1,2,3,4,8
  1. 1Coalition PLUS, Pantin, France
  2. 2INSERM, U912 (SE4S), Marseille, France
  3. 3Université Aix Marseille, IRD, UMR-S912, Marseille, France
  4. 4ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
  5. 5Alternatives-Cameroun, Douala, Cameroun
  6. 6Université de Yaoundé 1, Département de Sociologie, Yaoundé, Cameroun
  7. 7IRD, CEPED UMR 196, University Paris Descartes INED IRD, Paris, France
  8. 8AIDES, Pantin, France
  1. Correspondence to Bruno Spire, INSERM U912/ORS PACA, 23 rue Stanislas Torrents, 13006 Marseille, France; bruno.spire{at}
  • Accepted 10 August 2009
  • Published Online First 24 August 2009


Objectives Research on men who have sex with men (MSM) in sub-Saharan Africa was neglected for a long time. The objective of this study was to understand factors associated with unprotected anal intercourse (UAI) with male partners among a group of MSM living in the city of Douala, Cameroon.

Methods In 2008, a survey on the sexual activity and practices of MSM was set up in Douala in collaboration with a local community-based organisation. Data were collected among a convenience sample of 168 MSM during face-to-face interviews with trained interviewers.

Results A total of 142 individuals reported sexual activity during the previous 6 months, among whom 80 (57%) reported UAI with male partners. In a multivariate logistic regression model adjusted for the frequency of sexual intercourse, not having had access to prevention interventions and not knowing any HIV-infected person were both independently associated with a higher risk of UAI. Other factors associated with this higher risk included having had a stable male partnership at some point in one's life and not having been out of Douala for more than 4 weeks during the previous year.

Conclusions This community-based research is the first study of MSM in Cameroon and the HIV transmission risks they face. Results show the importance of HIV prevention interventions from peers, and underline the need to maintain efforts to develop specific interventions targeting MSM more efficiently in the African context.


  • Funding This study has received funding and technical support from AIDES, Pantin, France.

  • Competing interests None.

  • Patient consent Obtained.

  • Contributors EH and FM collaborated in the writing of the manuscript. EH was also involved in the design and conducting of the survey. YY and SN were involved in the design and conducting of the survey, as members of Alternatives–Cameroun. LF performed the statistical analyses. CG, JL, ET and FE revised the manuscript before submission, and complemented it with contextual data. BS chose the main directions for data analysis and participated in the interpretation of results.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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