Background Men who have sex with men (MSM) and transgender women (TW) experience a disproportionate HIV burden in Myanmar. Relatively little data characterising HIV among MSM and TW in Myanmar exists, and there are no published estimates of HIV incidence.
Methods We implemented an electronic data management system (eDMS) at two community-based HIV testing clinics targeting MSM and TW. Unique identifiers were used to longitudinally track HIV testing and sexual risk behaviours, and socio-demographic data was captured at first visit. Baseline HIV prevalence, examined correlates of HIV positivity using logistic regression, HIV incidence among clients receiving more than one HIV test over the observation period was calculated
Results 2867 MSM and TW clients were tested over 15months. At first test, 37% reported a lifetime history of HIV testing, 74% reported sex with casual male partners in the p3months, and 28% reported consistent condoms use with casual partners. 291 clients tested HIV positive at their first test (prevalence=10·4%;95%CI: 9·3–11·6). Positivity was significantly associated with self-identifying as Apone (local label describing non-disclosing MSM; aOR 9.1; 95%CI:3·8–22.2) or Apwint (local label used describing TW;aOR: 12.0;95%CI: 4·0–36·0), age 26–39 years (aOR 2·9;95%CI: 1·6–5·3) and reporting no lifetime history of HIV testing (aOR:4·6; 95%CI:2·3–9·4). Twelve incident cases were detected among clients receiving more than one test (n=279) and incidence was 10.1 per 100 person years (95%CI:5·73–17·8).
Conclusion To our knowledge, this is the first HIV incidence estimate for MSM and TW in Myanmar, higher than other regional estimates for MSM and TW. A HIV diagnosis at the first test was associated with sexual identification, younger age and testing history, suggest a high level of HIV transmission and protracted periods of undiagnosed HIV. Imperatives for Myanmar’s national response include promotion of timely and regular testing behaviours, outreach strategies tailored to age and sexual identity and the ongoing monitoring of HIV trends.
Disclosure No significant relationships.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.