Background
The HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study’s objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.
Methods
Dried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.
Results
Of the 2,450 participants (baseline and endline), 453 (18%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 8%), likely due to most study participants being virally suppressed (87%). Among these sequences, 13 (36%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 77%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 85%).
Conclusions
Our findings suggest that GBMSM in Kenya who seek partners through different venues –physical hotspots or online – may have unique and unmet HIV prevention, testing, and treatment needs. Consequently, consideration by programs as to the needs of diverse GBMSM in Kenya across venues is required in order to address their unmet HIV prevention, testing and treatment needs.
