HIV prevalence and risk behaviours among men having sex with men in Nigeria
- Mike Merrigan1,
- Aderemi Azeez2,
- Bamgboye Afolabi3,
- Otto Nzapfurundi Chabikuli4,
- Obinna Onyekwena4,
- George Eluwa4,
- Bolatito Aiyenigba5,
- Issa Kawu2,
- Kayode Ogungbemi6,
- Christoph Hamelmann4
- 1AED, Gaborone, Botswana
- 2Federal Ministry of Health, HIV/AIDS Division, Abuja, Nigeria
- 3Department of Medical Statistics, University College Hospital, Ibadan, Nigeria
- 4Family Health International, Abuja, Nigeria
- 5US Centers for Disease Prevention and Control, Abuja, Nigeria
- 6National Agency for the Control of AIDS, Abuja, Nigeria
- Correspondence to Dr Mike Merrigan, AED Botswana, PO Box 3780, Gaborone, Botswana;
Contributors MM coordinated technical assistance for the project, compiled inputs from other authors, authored the discussion and prepared the final draft of the paper. KO and AA oversaw the field work, guided the analysis, edited the paper and endorsed the results. BA prepared the first draft of the paper. ONC and CH provided technical oversight of the project and substantial inputs into the analysis, presentation and interpretation of results. OO and GE led the RDS design and implementation team and performed statistical analyses. BA and IK directly managed the field work and provided substantial inputs into the final paper.
- Accepted 21 May 2010
- Published Online First 6 September 2010
Objective To evaluate HIV and syphilis prevalence among men who have sex with men (MSM) in Nigeria, and assess their HIV-related risk behaviours and exposure to HIV prevention interventions.
Methods Cross-sectional study using respondent-driven sampling conducted in Lagos, Kano and Cross River states, Nigeria, between July and September 2007.
Results A total of 879 MSM participated, 293 from each state. Eight participants (1.1%, CI 0.1% to 2.2%) in Cross River, 27 (9.3%, CI 5.7% to 15.4%) in Kano and 74 (17.4%, CI 12.3% to 23.2%) in Lagos tested positive for HIV. No syphilis was detected. The median age was 22 years. MSM reported an average of 4.2 male anal sex partners in the past 6 months. Between 24.4% (Lagos) and 36.0% (Kano) of MSM reported selling sex to other men. Up to 49.7% of MSM reported sex with a girlfriend and ≤6.5% purchased sex from female sex workers. Consistent condom use in commercial sex with other men over the past 6 months ranged from 28.0% (Cross River) to 34.3% (Kano), in contrast to between 23.9% (Kano) and 45.8% (Lagos) for non-commercial sex. Associations with HIV positivity included age in the three states, having been the receptive partner in anal sex in the past 6 months in Lagos and in Lagos and Kano feeling at risk of HIV.
Conclusion Large differentials in HIV prevalence between states together with high mobility, inconsistent condom use and behavioural links with female sex partners, have the potential for further HIV transmission within MSM networks, and between MSM and the general population.
Funding United States Agency for International Development and US Center for Disease Control and Prevention.
Competing interests None.
Ethics approval This study was conducted with the approval of the Protection of Human Subjects Committee (PHSC) of Family Health International North Carolina, the US Centers for Disease Prevention and Control and the National Institute for Medical Research (NIMR), Nigeria.
Provenance and peer review Not commissioned; externally peer reviewed.