Objectives In many populations, men who have sex with men (MSM) are at a high risk of HIV infection. This study aimed to estimate the burden of HIV, other STIs and risk behaviours among Rwandan MSM.
Methods In this cross-sectional study, we recruited through peer referral men aged between 18 and 60 years, who reported sex with men at least once in the 12 months prior to the survey. Representativeness was increased using ‘seeds’ from a variety of sources. Signed informed consent was obtained from all participants. Data on demographics, risk behaviours and self-reported STIs were collected through an interviewer-administered questionnaire. We screened all eligible participants for HIV using the Rwanda-approved protocol for rapid HIV detection.
Results 504 MSM were recruited from five major cities in Rwanda. Participants were mostly young (median age 23 years, range 18–55 years) and unmarried (484/504, 96.0%). Thirteen per cent (65/504) of the participants reported past gonorrhoea and/or syphilis infection. Of 504 MSM, 53 (10.5%) reported they were diagnosed and treated for gonorrhoea in the past 12 months and 24 (4.8%) tested positive for HIV. A high proportion (232/504, 46%) reported receiving payment for sex by a man, with almost half of these reporting on more than three occasions (107/232, 46%). Many reported having had an HIV test within the past 12 months (385/504, 76.4%). In multivariate logistic regression models controlling for age, being paid for sex was associated with higher odds of past STI (OR 3.36 (1.82–6.43]; P<0.001) and testing HIV positive (OR 3.13, P<0.05).
Conclusion Further research is needed to understand the high rate of payment for sex in this population, which appears to be a major risk factor for STI including HIV.
- infectious diseases
- tropical stds
- neisseria gonorrhoea
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Handling editor Jackie A Cassell
Contributors RSN conceived and designed the study, supervised data collection, analysed the data, interpreted the results, wrote the first draft of the manuscript and revised the final version of the manuscript. GR, PM and ES supervised data collection, interpreted the results and revised the final version of the manuscript. JG participated in the analysis of the data, interpreted the results and revised the final version of the manuscript. SDWF conceived and designed the study, supervised data collection, performed the statistical analyses, interpreted the results, collaborated with RSN in the writing of the first draft of the manuscript and revised the final version of the manuscript. PK conceived and designed the study, supervised data collection, interpreted the results and revised the final version of the manuscript.
Funding This work was supported by Training Health Researchers into Vocational Excellence in East Africa (THRiVE), grant number 087540 funded by the Wellcome Trust. This work was also supported by the University of Rwanda SIDA grant number 51160027 and by an MRC Methodology Research Programme grant (MR/J013862/1) to SF.
Competing interests None declared.
Patient consent Obtained.
Ethics approval University of Rwanda Institutional Review Board (approval number CMHS/IRB/164/2015).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Given the sensitive nature of HIV-related data, we have not made the raw data open access. To obtain a copy of the data and the associated R scripts for statistical analysis, please contact the corresponding author.
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