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Risk Factors Associated with HIV Among Men Who Have Sex Only with Men and Men Who Have Sex with Both Men and Women in Three Urban Areas in Mozambique

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Abstract

Using respondent-driven sampling (RDS), an integrated biological behavioral survey among men that have sex with men (MSM) enrolled 457 participants in Maputo [63.0 % were MSM who had sex with women (MSMW)], 538 in Beira (36.2 % MSMW) and 330 in Nampula-Nacala (54.8 % MSMW) in 2011. Analysis suggests that MSM who have sex only with men (MSMO) had increased odds of having HIV (aOR 2.7) compared to MSMW. HIV among MSMO associated with age, self-reported STI (aOR 4.2), having a single male anal partner (aOR 3.8) and having transactional sex with a man (aOR 3.5) in the past year. Among MSMW, HIV associated with age, lower education (aOR 32.5), being uncircumcised (aOR 3.1) and having transactional sex with a woman (aOR 6.0) in the past year. Findings confirm that MSMO and MSMW have distinct HIV risks in Mozambique; HIV programs for MSM in Southern Africa should take such differences into consideration.

Resumen

Por uso de muestreo dirigido por los participantes (RDS), el estudio biológico y conductual integrado entre los hombres que tienen sexo con hombres (HSH) registro 457 participantes en Maputo (63,0 % HSHM), 538 en Beira (36,2 % HSHM) y 330 en Nampula-Nacala (54,8 % HSHM). El análisis revelo que los HSH que tienen sexo apenas con otros hombres (HSHO) tenían probabilidad más alta de tener VIH que los HSHM (ORa: 2,7). VIH entre los HSHO se asoció con la edad, el auto-relato de ITS (ORa: 4,2), tener un único compañero sexual anal en los últimos 12 meses (ORa: 3,8) y sexo transaccional con un hombre (ORa: 3,5). Entre los HSHM, el VIH se asoció con la edad, menor escolaridad (ORa: 32,5), nunca haber sido circuncidado (ORa: 3,1) y sexo transaccional con una mujer (ORa: 6,0). Los resultados confirman que los HSHO y HSHM tienen riesgos de VIH distintos. Los programas del VIH para los HSH en la África Austral debían tomar en consideración estas particularidades.

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Acknowledgments

The authors would like to thank the study participants for accepting to be part of this study, the study field team and members of the integrated biological and behavioral surveillance Mozambique technical working group for their dedication in the study planning and execution processes, as well as all implementing institutions for their support in all phases of the study. This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Department of Health and Human Services and the Centers for Disease Control and Prevention (CDC) Mozambique Country Office under the terms of Cooperative Agreement Number U2GPS001468. The views expressed in this report do not necessarily reflect the views of the US Centers for Disease Control and Prevention or the U.S. Government.

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Authors and Affiliations

  1. International Training and Education Center for Health, P.O. BOX 364, Maputo, Mozambique

    Isabel Sathane

  2. Global Health Sciences, University of California San Francisco, San Francisco, CA, USA

    Roberta Horth, Tim Lane, H. Fisher Raymond & Willi McFarland

  3. Division of Global HIV/AIDS, U.S. Centers for Disease Control and Prevention, Maputo, Mozambique

    Peter Young & Beverley Cummings

  4. Department of Anthropology, University of Washington, Seattle, WA, USA

    Celso Inguane

  5. Instituto Nacional de Saúde, Maputo, Mozambique

    Rassul Nalá

  6. Universidade Federal do Espírito Santo, Vitória, Brazil

    Angelica E. Miranda

  7. San Francisco Department of Public Health, San Francisco, CA, USA

    H. Fisher Raymond & Willi McFarland

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  1. Isabel Sathane
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Correspondence to Isabel Sathane.

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Sathane, I., Horth, R., Young, P. et al. Risk Factors Associated with HIV Among Men Who Have Sex Only with Men and Men Who Have Sex with Both Men and Women in Three Urban Areas in Mozambique. AIDS Behav 20, 2296–2308 (2016). https://doi.org/10.1007/s10461-016-1390-1

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