Men Who Have Sex with Men in Mozambique: Identifying a Hidden Population at High-risk for HIV

Abstract

The population of men who have sex with men (MSM) has been largely ignored in HIV-related policies and programming in Mozambique and there is little information about the contribution of MSM to the HIV epidemic. An integrated biological and behavioral study among MSM using respondent-driven sampling was conducted in 2011 in Maputo, Beira and Nampula/Nacala. Men who reported engaging in oral or anal sex with other men in the last 12 months answered a questionnaire and provided a blood sample for HIV testing. The prevalence of HIV was 8.2 % (Maputo, n = 496), 9.1 % (Beira, n = 584) and 3.1 % (Nampula/Nacala, n = 353). Prevalence was higher among MSM ≥ 25 vs. 18–24 years: 33.8 % vs. 2.4 % (p < 0.001), 32.1 vs. 2.8 % (p < 0.001), and 10.3 vs. 2.7 % (p < 0.06), in each city respectively. The difference in prevalence demonstrates the need to increase prevention for younger MSM at risk for HIV and ensure care and treatment for older HIV-infected MSM.

Substance Use and HIV Risk Among Men Who Have Sex With Men in Africa: A Systematic Review

“…12,19,23,24,49,65–67 Sandfort et al 21 found that men in South Africa who tested HIV-positive in the study were more likely to be categorized as hazardous drinkers as measured by the AUDIT than HIV-negative men (54.5% versus 40.0%; AOR: 1.81; 95%CI: 1.06, 3.07). Baral et al 68 reported that men in Swaziland who drank alcohol at least one day in the preceding month were not more likely to be HIV infected than other men (AOR based on weighted data: 2.18; CI95%: 0.60, 7.95).…”

“…Based on the AUDIT, Sandfort et al 21 classified 44.4% of the men in a South African study as hazardous drinkers; Lane et al 24 reported that almost all of the MSM in South African rural areas in their study met AUDIT-C criteria for alcohol misuse; in Mozambique proportions of hazardous drinkers based on the AUDIT-C varied by town, ranging from 32.3% to 43.8%. 49 Among MSM in Kenya, Muraguri et al 32 estimated 22.7% of the men to be alcohol dependent. In his study among South African MSM, Lane et al 30 created three categories of men: irregular drinkers (men who drank alcohol less than once per week and were drunk less than once a week); regular drinkers (men who drank alcohol once a week or more and were drunk less than once a week); and regular drinkers to intoxication (men who drank alcohol once a week or more, and were drunk once a week or more), with 36.1%, 23.8%, and 40.1% of the men filling these categories, respectively.…”

“…However, Rebe et al 55 reported that 37% of MSM patients at a health clinic in Cape Town reported ever having used crystal methamphetamine; use was much lower among Black MSM compared to White and Coloured/other MSM (19%, 32%, and 57%, respectively). Use of specific drugs varied within countries; Nalá et al 49 reported prevalence of cannabis use in the preceding 12 months among MSM in Mozambique ranging from 4.0% (Nampula/Nacala) to 11.8% (Maputo). Likewise, Lane et al 23 reported a prevalence of 0.4% and 8.2% of cannabis use in two separate South African study sites.…”

Recruiting the social contacts of patients with STI for HIV screening in Lilongwe, Malawi: process evaluation and assessment of acceptability

“…This finding has important implications; finding one person from a specific hard-to reach population could serve as a gateway to others from this same population. This phenomenon has been observed with frequency in sub-Saharan African high-risk populations, such as sex workers, injection drug users and men who have sex with men, [17][18][19][20][21][22][23] but this phenomenon is less well described among patients with STI who primarily experience risk from heterosexual sexual contact with the general population. [24][25][26][27] This observation is important since heterosexual transmission in the general population is the primary source of HIV transmission in sub-Saharan Africa.…”

Regarding realities: Using photo-based projective techniques to elicit normative and alternative discourses on gender, relationships, and sexuality in Mozambique

“…Anthropological work has broadened understanding of the range of personal and family motives for sexual risk-taking and risk protection across economic classes (Groes-Green, 2009a, 2012, 2013. Authors have proposed how health and social marketing can improve to address HIV risk communication for Mozambicans, especially for community subgroups (Baltazar et al, 2015;Nalá et al, 2015), and have shed light on why some MSP communication fails to resonate with marginalised populations (GroesGreen, 2009a).…”