Using a social ecological framework to characterize the correlates of HIV among men who have sex with men in Lomé, Togo.
Identifieur interne : 000001 ( Main/Exploration ); précédent : 000000; suivant : 000002Using a social ecological framework to characterize the correlates of HIV among men who have sex with men in Lomé, Togo.
Auteurs : Horacio Ruise Or-Escudero [États-Unis] ; Ashley Grosso [États-Unis] ; Sosthenes Ketende [États-Unis] ; Vincent Pitche [Togo] ; Anato Simplice [Togo] ; Jules Tchalla [Togo] ; Dometo Sodji [Togo] ; Ben Liestman [États-Unis] ; Laurent Kapesa [Ghana] ; Stefan Baral [États-Unis]Source :
- AIDS care [ 1360-0451 ] ; 2017.
Abstract
In the mixed and concentrated HIV epidemics of West Africa, the relative disproportionate burden of HIV among men who have sex with men (MSM) compared to other reproductive-age men is higher than that observed in Southern and Eastern Africa. Our aim is to describe the correlates of HIV infection among MSM living in Lomé, Togo, using the Modified Social Ecological Model (MSEM). A total of 354 MSM ≥18 years of age were recruited using respondent driven sampling (RDS) for a cross-sectional survey in Lomé, Togo. Participants completed a structured questionnaire and were tested for HIV and syphilis. Statistical analyses included RDS-weighted proportions, bootstrapped confidence intervals (CI), and logistic regression models. Mean age of participants was 22 years; 71.5% were between 18 and 24 years. RDS-weighted HIV prevalence was 9.2% (95% CI=5.4-13.2). In RDS-adjusted (RDSa) bivariate analysis, HIV infection was associated with disclosure of sexual orientation to a family member, discriminatory remarks made by family members, forced sex, ever being blackmailed because of being MSM, community and social stigma and discrimination, and health service stigma and discrimination. In the multivariable model, HIV infection was associated with being 25 years or older (RDSa adjusted OR (aOR)=4.3, 95% CI=1.5-12.2), and having sex with a man before age 18 (RDSa aOR=0.3, 95% CI=0.1-0.9). HIV prevalence was more than seven times higher than that estimated among adults aged 15-49 living in Togo. Using the MSEM, network, community, and policy-level factors were associated with HIV infection among MSM in Lomé, Togo. Through the use of this flexible risk framework, a structured assessment of the multiple levels of HIV risk was characterized, highlighting the need for evidence-based and human-rights affirming combination HIV prevention and treatment programs that address these various risk levels for MSM in Lomé.
DOI: 10.1080/09540121.2017.1280122
PubMed: 28132516
Affiliations:
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xml:lang="en">In the mixed and concentrated HIV epidemics of West Africa, the relative disproportionate burden of HIV among men who have sex with men (MSM) compared to other reproductive-age men is higher than that observed in Southern and Eastern Africa. Our aim is to describe the correlates of HIV infection among MSM living in Lomé, Togo, using the Modified Social Ecological Model (MSEM). A total of 354 MSM ≥18 years of age were recruited using respondent driven sampling (RDS) for a cross-sectional survey in Lomé, Togo. Participants completed a structured questionnaire and were tested for HIV and syphilis. Statistical analyses included RDS-weighted proportions, bootstrapped confidence intervals (CI), and logistic regression models. Mean age of participants was 22 years; 71.5% were between 18 and 24 years. RDS-weighted HIV prevalence was 9.2% (95% CI=5.4-13.2). In RDS-adjusted (RDSa) bivariate analysis, HIV infection was associated with disclosure of sexual orientation to a family member, discriminatory remarks made by family members, forced sex, ever being blackmailed because of being MSM, community and social stigma and discrimination, and health service stigma and discrimination. In the multivariable model, HIV infection was associated with being 25 years or older (RDSa adjusted OR (aOR)=4.3, 95% CI=1.5-12.2), and having sex with a man before age 18 (RDSa aOR=0.3, 95% CI=0.1-0.9). HIV prevalence was more than seven times higher than that estimated among adults aged 15-49 living in Togo. Using the MSEM, network, community, and policy-level factors were associated with HIV infection among MSM in Lomé, Togo. Through the use of this flexible risk framework, a structured assessment of the multiple levels of HIV risk was characterized, highlighting the need for evidence-based and human-rights affirming combination HIV prevention and treatment programs that address these various risk levels for MSM in Lomé.</div></front></TEI><affiliations><list><country><li>Ghana</li><li>Togo</li><li>États-Unis</li></country><region><li>Maryland</li><li>Michigan</li></region></list><tree><country name="États-Unis"><region name="Michigan"><name sortKey="Ruise Or Escudero, Horacio" sort="Ruise Or Escudero, Horacio" uniqKey="Ruise Or Escudero H" first="Horacio" last="Ruise Or-Escudero">Horacio Ruise Or-Escudero</name></region><name sortKey="Baral, Stefan" sort="Baral, Stefan" uniqKey="Baral S" first="Stefan" last="Baral">Stefan Baral</name><name sortKey="Grosso, Ashley" sort="Grosso, Ashley" uniqKey="Grosso A" first="Ashley" last="Grosso">Ashley Grosso</name><name sortKey="Ketende, Sosthenes" sort="Ketende, Sosthenes" uniqKey="Ketende S" first="Sosthenes" last="Ketende">Sosthenes Ketende</name><name sortKey="Liestman, Ben" sort="Liestman, Ben" uniqKey="Liestman B" first="Ben" last="Liestman">Ben Liestman</name></country><country name="Togo"><noRegion><name sortKey="Pitche, Vincent" sort="Pitche, Vincent" uniqKey="Pitche V" first="Vincent" last="Pitche">Vincent Pitche</name></noRegion><name sortKey="Simplice, Anato" sort="Simplice, Anato" uniqKey="Simplice A" first="Anato" last="Simplice">Anato Simplice</name><name sortKey="Sodji, Dometo" sort="Sodji, Dometo" uniqKey="Sodji D" first="Dometo" last="Sodji">Dometo Sodji</name><name sortKey="Tchalla, Jules" sort="Tchalla, Jules" uniqKey="Tchalla J" first="Jules" last="Tchalla">Jules Tchalla</name></country><country name="Ghana"><noRegion><name sortKey="Kapesa, Laurent" sort="Kapesa, Laurent" uniqKey="Kapesa L" first="Laurent" last="Kapesa">Laurent Kapesa</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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