P1-S2.55 High incidence of HIV and low HIV prevention coverage among men who have sex with men in Managua, Nicaragua

Abstract

Background High rates of HIV and sexually transmitted infections (STI) are found in men who have sex with men (MSM) in Nicaragua. This study investigated HIV, STI, and risk behaviours in MSM. Methods From 9/2009 to 2/2010, MSM 18 years or older who gave written informed consent and reported having anal sex with a man in the last year were recruited using respondent-driven sampling in Managua. The survey process included audio computer assisted survey instruments (ACASI) and face-to-face interviews followed by STI counselling and specimen collection for HIV (Uni-Gold RecombigenÒ, DetermineÒ, HIV Elisa and Western Blot), HSV-2 (Elisa IgG FocusÒ Technology, Inc), and syphilis testing (RPR/ TPPA). Gonorrhoea, Chlamydia, Mycoplasma genitalium and Trichomonas were tested by PCR. The BED IgG capture enzyme immunoassay was applied to HIV positive specimens to detect recently-acquired HIV infections, used to estimate HIV incidence. Population proportions and 95% CIs were calculated and adjusted for RDS-sampling weights. Incidence estimates were adjusted using a locally-established false-recent rate for the assay. Data analyses were conducted in STATA 9.0 and RDSAT 6.1. Results Respondents self-identified as bisexual (50%), gay (41%), heterosexual (1%) or transgender (8%). In the last year, 34.5% had one or more stable partner and 66% had occasional partners. Sex with women during lifetime was reported by 66% and 40% in the last year. Consistent condom use (last 30 days) was reported at 31% with stable male partner, 12%, with stable female partner, 38% with occasional partner, and 38% with clients. Condom use in last sex was 62%. Overall, 36% had received peer-driven outreach for HIV prevention and 64% had been tested for HIV in the last year. HIV prevalence in Managua was determined to be 7.5% (CI 4.5% to 11%), incidence 2.9% (CI 0.2% to 5.6%). Herpes simplex 2 was the most prevalent STI at 39.9% (CI 34.4% to 46%) see Abstract P1-S2.55 Table 1. Conclusions The 2003 Multicentric Study found a similar prevalence in Managua among MSM at 9.4% (CI 5.3% to 14.8%). Condom use is low with all types of partners, but lowest with female partners. The population's high HIV incidence, coupled with low access to education, underlines the urgency of enhancing prevention activities among this population. Stronger strategies are needed to ensure that prevention, care, and treatment interventions reach this population. Methods In a retrospective study we analysed the laboratory data of 16 HCV positive/HIV positive MSM (cases), HCV diagnosis in 2010, and 32 HCV negative/HIV positive MSM (controls), followed at the HIV/ STI clinic in Antwerp, Belgium. All laboratory confirmed STI episodes (syphilis, gonorrhoea, lymphogranuloma venereum, and rectal and urethral non-LGV chlamydial infections) were recorded since the date of presentation at our clinic, until the date of HCV diagnosis of the cases. Controls were selected from consecutive patients that consulted on the same day. Both cases and controls were regularly followed up at the clinic in...

Prevalence of Mycoplasma genitalium in different population groups: systematic review andmeta-analysis

“…Five studies from four records enrolled MSM from the community ( figure 3 , online supplementary table S4 ) in specific areas in Australia 2, 31 El Salvador 1, 32 Guatemala 1 and Honduras 3, 33 and Nicaragua 1, 34 (n=3012). The summary average prevalence in these studies was 3.2% (95% CI 2.1% to 5.1%, I 2 78.3%) with moderate between study heterogeneity.…”

Prevalence ofMycoplasma genitaliumin different population groups: systematic review and meta-analysis

“…We screened the titles and abstracts of 3,316 unique records published after 1991 and the full text of 833 studies (Figure S1 in online Appendix). A total of 63 records was included with participants who were; sampled at random from the general population [19][20][21][22][23][24] or using alternative community-based methods, [25][26][27][28][29] MSM and male-to-female transgendered, [30][31][32][33][34][35] FSW, [36][37][38][39][40] and pregnant women. [41][42][43][44] Of these, 37 studies included patients attending healthcare settings.…”

Prevalence of infectious diseases and its associated factors among the blood donors of the Honduran Red Cross – Northern Region between 2014 and 2016

“…This change in the demographics of HIV infection is mostly attributed to various anatomical, histological, and social factors [ 22 ], as well as to sexual practices among various groups. A 2010 report in Nicaragua indicated that a large percentage of homosexual men also had sex with women [ 23 ]. Based on this report, the incidence of HIV infection among men who have sexual relationships with men is low, whereas that among heterosexuals is high [ 24 ].…”