Transcript Powerpoint - AIDS 2014

DRUG USE AND SEXUAL RISK
BEHAVIOURS AMONG MEN WHO
HAVE SEX WITH MEN IN KADUNA
METROPOLIS, NORTH CENTRAL
NIGERIA
I. Suleiman1, O. Otibho1, J. Njab1, S. Sangowawa1, A. Oginni1,
G. Eluwa1, S. Adebajo1, B. Ahonsi1, B. Keshinro2, T. Kene2
1Population
Council Nigeria; 2Walter Reed Program—Nigeria (WRP-N)
AIDS 2014, 20th International AIDS Conference
Melbourne, Australia
July 20 – 25, 2014
Background
• Recreational drug use is associated with
engaging in risky sexual risk behaviours which
may lead to increased risk of HIV exposure.
• In Nigeria, little attention has been paid to the
effects of recreational drug use and alcohol on
the HIV vulnerabilities of men who have sex
with men (MSM).
• Study aimed to determine the association
between recreational drug use and sexual risk
behaviours among MSM in Kaduna Metropolis.
Methods
• Data collected on sexual risk behaviours and
HIV sero-status with a structured HIV testing
and counseling client intake form
– Administered to MSM at a community health clinic
in Kaduna State
• Descriptive (frequencies and percentages) and
inferential analyses (multivariate binary logistic
regression) of the data were conducted.
Kaduna State, Nigeria
• Located in the North West
Geo-Political Zone of
Nigeria.
• Former headquarters of the
Northern Region.
• Population: 6,113,503.
• Religion: 56% Muslims, 46%
Christians.
• Social and political center.
• Cosmopolitan.
Clinic
• Located in Kaduna south
• Clients are mainly key
population
• Access to MSM through
peer referrals from Key
Opinion Leaders
• Referrals from other
prevention programmes
and implementing
organizations working with
key populations
• 1,470 MSM accessed
clinic between May 2013
to January 2014
Characteristics of the clients
• Of the 1,470 MSM who accessed the clinic:
– ~53% aged 15–24 years
– 68% had secondary school education
– 48% were employed
– 39% were students
– 11% were married
Recreational drug and alcohol use in
the last 6 months
70
64.3
60
Percent
50
40
35.7
30
20
10
0
23.2
18.6
0.5
0.6
2.7
0.3
HIV knowledge and risk behaviors
• 77% engaged in unprotected sex with a casual
partner in past 3 months
• 72% engaged in transactional sex in past 6 months
• 61% in multiple sexual partnerships
• 56% had comprehensive knowledge of HIV (UNAIDS)
Indicator
• ~11% reported a history of STIs in past 6 months
• 5.6% tested positive for HIV from the 1,470 MSM
who under went HIV counseling and testing (HCT)
Associations between drug use and
sexual behavior
• MSM who used recreational drugs were more likely to have engaged in
unprotected sex, transactional sex, and multiple sexual partnerships
compared to those that did not
Recreational
drug use
Had unprotected sex
Transactional sex
Multiple sexual partnership
%
COR
AOR
%
COR
AOR
%
COR
AOR
No
72.3
1.00
1.00
66.9
1.00
1.00
43.4
1.00
1.00
Yes
84.8
2.13
3.67
81.1
2.13
3.90
92.8
16.72
9.36
(1.62,
(2.66,
(1.65,
(2.91,
(11.73,
(6.39,
2.82)
5.05)
2.76)
5.24)
23.83)
3.72)
Controlled for occupation, marital status, HIV status, history of STIs, and comprehensive knowledge of HIV
Conclusions
• Drug and alcohol use is common; injecting drug
use not common.
• Drug and alcohol use among MSM is high and
is associated with sexual risk behaviours.
• Interventions for MSM should address risks
associated with both sexual behaviours and
recreational drug and alcohol use.
• MSM-friendly clinics can be an effective way to
reach a high number of MSM and provide risk
reduction services.
Acknowledgements
• Study participants
• HIV and AIDS Division, Population Council, Nigeria
• Walter Reed Programme, Nigeria (WRP-N)
• US Military Health Research Programme (MHRP)
This research has been supported by the President’s
Emergency Plan for AIDS Relief (PEPFAR) through U.S.
Department of Defense. The views expressed are those of
the authors and should not be construed to represent the
positions of the U.S. Army or the Department of Defense.
Ideas. Evidence. Impact.
The Population Council conducts research
and delivers solutions that improve lives
around the world. Big ideas supported by
evidence: It’s our model for global change.