Bisexual and Bidirectional: Assessing the Potential for HIV Bridging in Mozambique

Abstract

African men who have sex with men (MSM) frequently, and often concurrently, have female partners, raising concerns about HIV sexual bridging. We explored potential HIV transmission in Mozambique from and to female partners of MSM focusing on preferred anal sex role and circumcision status. Data collected in a respondent-driven sampling study of MSM in 2011 in Maputo and Beira. Men who had oral or anal sex with other men 12 months prior completed a questionnaire and consented for HIV testing. Statistical analysis explored demographic/risk characteristics and associations among circumcision status, anal sex with men, sexual positions during anal sex with men and vaginal or anal sex with women. We identified 326 MSM in Maputo and 237 in Beira with both male and female partners 3 months before the study. Of these, 20.8% in Maputo and 36.0% in Beira had any receptive anal sex with men 12 months prior, including 895 unprotected sexual acts with males in Maputo and 692 in Beira. Uncircumcised and exclusively insertive males, 27.7% of the sample in Maputo and 33.6% in Beira, had the most unprotected sex with females: 1159 total acts in Maputo and 600 in Beira. Sexual bridging between MSM and women likely varies geographically and is probably bi-directional, occurring within a generalized epidemic where HIV prevalence is higher among reproductive-age women than MSM. Prevention strategies emphasizing correct and consistent condom use for all partners and circumcision for bisexual men should be considered.

Sexual behaviours and risk with women in MSM in sub-Saharan Africa

“…Of these, only the 87 studies containing qualitative data or behavioral quantitative data referring to recent sexual relationships of MSM with women were selected for the present synthesis [26–118]. Details of selected studies are presented in Supplementary File 2, http://links.lww.com/QAD/D49.…”

Oral sex practices among men who have sex with men and transgender women at risk for and living with HIV in Nigeria

“…Our data expands on prior work, as it demonstrates an increased odds of oral sex with increasing number of male anal sexual partners, and decreased odds of oral sex with two or more female sexual partners independent of HIV status. Oral sex has been reported to be less common among MSMW as compared to MSM in several other settings [ 8 , 35 – 37 ]. In a study in the Southeastern United States, MSMW were 80% less likely to have 2 or more male oral sexual partners as compared to MSM-only [ 37 ].…”

“…partners independent of HIV status. Oral sex has been reported to be less common among MSMW as compared to MSM in several other settings [8,[35][36][37]. In a study in the Southeastern United States, MSMW were 80% less likely to have 2 or more male oral sexual partners as compared to MSM-only [37].…”

Recognizing the hidden: Strengthening the HIV surveillance system among key and priority populations in Mozambique

“…There has been a systematic approach to the use and dissemination of data for the development of abstracts for international conferences and manuscripts for international peer-reviewed journals of both INS staff and students interested in using the BBS data for their thesis and dissertation work. To date, sixteen manuscripts have been published or are under review in peer-reviewed journals (13)(14)(15)(16)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45), and six students have used BBS data for their dissertations (undergraduate, masters, and doctorate). These abstracts and manuscripts have bene ted from systematic and ongoing support from INS leadership and partner organizations.…”