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

Baltazar, Cynthia Semá; Boothe, Makini; Langa, Denise Chitsondzo; Sathane, Isabel; Horth, Roberta; Young, Peter W.; Schaad, Nick; Raymond, Henry F.

doi:10.1186/s12889-020-10110-y

Cited by 10 publications

(15 citation statements)

References 23 publications

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“…However, the risk profile of FSWs who use illicit drugs in our study is consistent with what has been observed in other studies among key populations (KP) in Mozambique. These studies consistently show that drug use tends to occur more frequently in younger individuals with a higher number of sexual partners, and it is associated with higher HIV and STI prevalence [ 19 , 39 ]. Several additional studies demonstrate that there is a strong relationship between substance use and unsafe sexual practices that increases the risk for HIV and STIs [ 7 , 30 , 36 , 40 – 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…An estimator is used to produce weights for each participant that are used to generate population proportions of estimates and corresponding standard errors. Details about the survey methodology are described elsewhere [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

“…The BBS surveys carried out with FSW in Mozambique included young women aged 15–17. This decision is well documented and was made after careful consideration, drawing on evidence from previous research indicating that this data is crucial for devising effective policies and programs targeted at this high-risk HIV group [ 19 , 21 – 23 ].…”

Section: Methodsmentioning

confidence: 99%

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Prevalence and correlates of hazardous alcohol drinking and drug use among female sex workers and men who have sex with men in Mozambique

Semá Baltazar,

Muleia,

Ribeiro Banze

et al. 2024

BMC Public Health

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Background Hazardous drinking and drug consumption are associated with an increased risk of HIV due to the complex interplay of factors influencing decision-making capability, stigma and social marginalization. In this study, we explore the patterns of hazardous alcohol and drug use and correlates of risk factors among female sex workers (FSW) and men who as sex with men (MSM) in Mozambique. Methods We conducted a secondary data analysis of bio-behavioral surveys (BBS) among FSW and MSM using a respondent-driven sampling methodology conducted in five main urban areas of Mozambique from 2019 to 20. The survey included a standardized questionnaire, where hazardous drinking was assessed (using AUDIT-C scores ≥ 4 for men, ≥ 3 for women) and drug use in the last year (FSW). Chi-squared test was used to analyze the association between socio-demographic and behavioral variables, and multivariate logistic regression measured the impact of the associated factors. Results The prevalence of hazardous alcohol drinking was 47.1% (95% CI:44.8–49.5) for FSW and 46.5 (95% CI: 44.0–49.0) for MSM. Current drug use was reported in 13.3% of FSW. FSW engaging in hazardous alcohol drinking reported more sexual partners in the last month than those no reporting hazardous alcohol use (55.3% vs. 47,1%, p < 0.001), higher rates of self-reported STIs in the last year (62,5% vs. 48,2%, p < 0.001), physical (53.5% vs. 46.7%, p < 0.0001) and sexual violence (54.7% vs. 44.2%, p < 0.001), and HIV prevalence (55.2% vs. 44.2 p < 0.001). Among MSM with hazardous alcohol drinking, there was a higher prevalence of self-reported STIs (52.8% vs. 45.4%, p < 0.001), experiences of sexual violence (18.0% vs. 8.3%, p < 0.001), and HIV prevalence (53.0% vs. 46.3%, p < 0.001). In addition, FSW who reported illicit drug use were more likely to self-reported HIV own risk (14.2% vs. 9.7%), early start sexual activity (15.4% vs. 5.3%), self-reported STIs (17.9% vs. 10.2%), and experiences of both physical (17.4% vs. 7.0%) and sexual violence (18.6% vs. 8.9%). Conclusion There is an immediate need for the introduction and integration of comprehensive substance use harm mitigation and mental health interventions into HIV prevention programs, particularly those targeting key populations in Mozambique.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Prevalence and correlates of hazardous alcohol drinking and drug use among female sex workers and men who have sex with men in Mozambique

Semá Baltazar,

Muleia,

Ribeiro Banze

et al. 2024

BMC Public Health

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“…In this method, an initial respondent is recruited based on network size and they are issued coupons and asked to invite additional participants from within their network. More details about the survey methodology are described elsewhere (10).…”

Section: Survey Design and Participantsmentioning

confidence: 99%

Amplifying the HIV Risks - Patterns of alcohol and drugs among female sex workers and men who as sex with men in Mozambique

Baltazar,

Muleia,

Banze

et al. 2023

Preprint

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Background: Abusive alcohol and drug consumption can increase the risk of acquiring HIV due to compromised decision-making linked to risky sexual behaviors. In this study, we explore the patterns of hazardous alcohol and drug use and correlates among female sex workers (FSW) and men who as sex with men (MSM) in Mozambique. Methods: We conducted a secondary data analysis of a bio-behavioral survey (BBS) using a respondent-driven sampling method, which was conducted in five main urban areas of Mozambique from 2019-21. Selection criteria for the MSM were being a biological male with at least 18 years of age and reported oral or anal intercourse with a man in the previous 12 months; FSWs criteria was being a biological female with at least 15 years of age and reported exchanging sex for money, services or goods in the previous 6 months. Results: The prevalence of hazardous alcohol drinking was 47.1% for FSW and 48.9% for MSM. Current drug use was reported in 13.3% of FSW. FSW with hazardous alcohol drinking were 47.1%. They reported higher number of sexual partners in the last month (55.3% vs 47,1%, p<0.001), STI in the last year (62,5% vs 48,2%, p<001), physical (53.5% vs 46.7%, p<0.0001) and sexual violence (54.7% vs 44.2%, p< 0.001), and HIV prevalence (55.2% vs 44.2 p<0.001). MSM with hazardous alcohol drinking was 48.9%. They reported higher STI (52.8%vs 45.4%, p<001), sexual violence (18.0% vs 8.3%, p<0.001) and HIV prevalence (53.0% vs 46.3 p<0.001). In addition, FSW that used drugs had a high perception of HIV risk, (14.2% vs 9.7%, p=0.005), had their first sexual experience when younger than 15 years old (15.4% vs 5.3% p<0.001), self-reported an STI (17.9% vs 10.2%, p< 0.001) in the last year, experienced physical violence (17.4% vs 7.0% p<0.001) and sexual violence (18.6% vs 8.9%, p<0.001). Conclusion: There is an immediate need for the introduction and integration of site-specific substance use harm mitigation and mental health interventions into HIV prevention programs, particularly those targeting key populations in Mozambique.

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“…High quality, representative data from HIV surveillance systems that have country ownership and commitment are critical for guiding national HIV responses, especially among KPs given their disproportionate role in the transmission of the virus [11]. Key Population specific data are more important than ever to guide the HIV response toward reaching the UNAIDS 95-95-95 targets.…”

Section: Introductionmentioning

confidence: 99%

The status quo on existing routine health information management systems that have incorporated key population unique identifier codes in Sub-Saharan Africa: Protocol for systematic review

Rampilo,

Phalane,

Phaswana-Mafuya

2024

Preprint

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Introduction: Despite having the world's largest HIV epidemic, Sub-Saharan Africa (SSA) including South Africa (SA) has not yet achieved the 95-95-95 targets. To meet these targets, accurate and reliable key populations (KPs) disaggregated data is critical for guiding the HIV response. The inclusion of KPs Unique Identifier Code (UIC) on country routine health information management systems (RHIMS) can improve targeted resource allocation, reporting, and accountability. There is a gap in comprehensive review on how countries that implemented the unique identifier code went about in doing so. Methods and analysis A three-step search strategy will be utilized to get both published and unpublished documents. First, an initial search of MEDLINE identified keywords and MeSH terms. Second, a systematic search of electronic bibliographic databases including MEDLINE, PubMed, Scopus, PLOS ONE and Google Scholar, and thirdly, searching the reference list of all included reviews (hand-searching journals and reference tracking). Studies that meet the following PICO (Population, Intervention, Comparison, Outcome) criteria will be included: P: Published and unpublished materials reporting on key populations, namely men who have sex with men (MSM), sex workers (SW), people who inject/use drugs (PWI/UD), and transgender (TG); I: biometric fingerprint, alphanumeric code and any KPs UIC system; C: no unique identifier system; and O: KPs-specific 95-95-95 HIV cascade, KPs knowing HIV status, KPs on ART, ART adherence and Viral load suppression. This protocol was prepared using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). References will be managed through ENDNOTE version 21 software. Two authors will screen the studies using Covidence software version 2.0 for inclusion according to the prescribed eligibility criteria. Differences will be addressed by consensus and with the assistance of an experienced third reviewer. Ethics and dissemination: This review will summarize findings from published studies containing non-identifiable data. The results will be disseminated via preprints, open-access peer-reviewed journals, and conference presentations. PROSPERO registration number: CRD42023440656

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

Cited by 10 publications

References 23 publications

Prevalence and correlates of hazardous alcohol drinking and drug use among female sex workers and men who have sex with men in Mozambique

Prevalence and correlates of hazardous alcohol drinking and drug use among female sex workers and men who have sex with men in Mozambique

Amplifying the HIV Risks - Patterns of alcohol and drugs among female sex workers and men who as sex with men in Mozambique

The status quo on existing routine health information management systems that have incorporated key population unique identifier codes in Sub-Saharan Africa: Protocol for systematic review

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