High HIV Seroprevalence, Rectal STIs and Risky Sexual Behaviour in Men Who Have Sex with Men in Dar es Salaam and Tanga, Tanzania
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Date
2014
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Abstract
Objectives: To assess HIV and sexually transmitted
infection (STI) prevalence and associated risk factors in
men who have sex with men (MSM) in two cities in
mainland Tanzania.
Methods: We conducted respondent-driven sampling
of 300 MSM in Dar es Salaam and Tanga.
Results: In Dar es Salaam, 172 (86%) men (median
age 23, IQR 21–28) consented to HIV/STI testing, and
30.2% were HIV seropositive. Only five reported a
previous positive HIV test: >90% were new HIV
detections. 2.5% were syphilis-exposed and none
hepatitis B positive, but 21.4% had a curable STI. Over
90% of the gonorrhoea and chlamydia was rectal. In
Tanga, 11.1% of MSM were HIV seropositive, 8%
hepatitis B positive and 0% were syphilis-exposed,
with 4.4% having a curable STI. Predictors of HIV
infection were number of MSM known, city, identifying
as gay and having first sex with a man. Predictors for
STIs were recent unprotected receptive anal
intercourse, and number of MSM seen in the last
month. 30% of the sample reported that they sold sex.
There was no significant association between HIV and
STI infection.
Conclusions: HIV and STI rates were substantially
lower in MSM in a provincial city than in a large
metropolis and rates appear to depend on larger
numbers of MSM known. Most HIV detected were new
cases, and there was a high burden of asymptomatic
curable rectal STIs (>1 in 5 MSM). Owing to stigma,
MSM may not report homosexuality and thus not have
rectal STIs treated. High need for tailored HIV testing
and STI screening and treatment of MSM in Tanzania
is apparent.
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Ross, M.W., Nyoni, J., Ahaneku, H.O., Mbwambo, J., McClelland, R.S. and McCurdy, S.A., 2014. High HIV seroprevalence, rectal STIs and risky sexual behaviour in men who have sex with men in Dar es Salaam and Tanga, Tanzania. BMJ open, 4(8), p.e006175.