Risk Factors for HIV and Unprotected Anal Intercourse among Men Who Have Sex with Men (MSM) in Almaty, Kazakhstan

Abstract

IntroductionMen who have sex with men (MSM) are at high risk for HIV infection. MSM in Central Asia, however, are not adequately studied to assess their risk of HIV transmission. Methods: This study used respondent driven sampling methods to recruit 400 MSM in Almaty, the largest city in Kazakhstan, into a cross-sectional study. Participation involved a one-time interviewer-administered questionnaire and rapid HIV screening test. Prevalence data were adjusted for respondent network size and recruitment patterns. Multivariate logistic regression was used to investigate the association between HIV and selected risk factors, and unprotected anal intercourse (UAI) and selected risk factors.ResultsAfter respondent driven sampling (RDS) weighted analysis, 20.2% of MSM were HIV-positive, and 69.0% had unprotected sex with at least one male partner in the last 12 months. Regression analysis showed that HIV infection was associated with unprotected receptive anal sex (AOR: 2.00; 95% CI: 1.04–3.84). Having unprotected anal intercourse with male partners, a measure of HIV risk behaviors, was associated with being single (AOR: 0.38; 95% CI: 0.23–0.64); very difficult access to lubricants (AOR: 11.08; 95% CI: 4.93–24.91); STI symptoms (AOR: 3.45; 95% CI: 1.42–8.40); transactional sex (AOR: 3.21; 95% CI: 1.66–6.22); and non-injection drug use (AOR: 3.10; 95% CI: 1.51–6.36).ConclusionsThis study found a high HIV prevalence among MSM in Almaty, and a population of MSM engaging in multiple high-risk behavior in Almaty. Greater access to HIV education and prevention interventions is needed to limit the HIV epidemic among MSM in Almaty.

Vulnerability in the context of HIV and syphilis infection in a population of men who have sex with men (MSM) in Salvador, Bahia State, Brazil

“…It was also lower than the results presented in the last report of the Joint United Nations Programme on HIV/AIDS (UNAIDS) (42%) 12 and in the Brazilian multicenter study (49%) 3 and other populations of MSM 42 . This is one of the most important indicators for monitoring the HIV epidemic, since it promotes a link between individuals and health services and can be one of the main entry points for healthcare via counseling and support for persons with HIV and other STI, allowing contact with information and preventive measures.…”

“…Lower access to lubricant gel was associated with a lifetime history of HIV infection and syphilis, and difficulty in access to lubricant gel has also been reported in other countries in the MSM population 38,42 . Lubricant gel is important for the prevention of HIV infection 12 .…”

“…Sexual category was associated with the result of the syphilis test (prevalence of syphilis and HIV was higher among homosexuals). The literature generally reports an association between sexual identity and risky sexual practices for HIV infection 12,29,38,42 , stigma 29 , difficult access to health services 31,43 , and HIV infection 26,43 .…”

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“…Many of the risk factors identified in the RDS survey are also commonly reported worldwide by previous studies (Baral et al, 2009;Berry et al, 2012;Choi, Ayala, Paul, Boylan, & Gregorich, 2013;Zhang et al, 2013). While in the TLS survey, only having a low income and having male sex partners only (vs. having both male and female partners) were associated with HIV infection.…”

Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need

“…While rates have remained low and relatively stable across much of western and central Europe, with rates rarely above 4% ever having injected,4 5 this drug delivery method has been shown to be more common in central Asia,6 Russia7 and parts of Sub-Saharan Africa 8. Analysis of community survey data from 2011 in Sydney, Australia, found that 5.0% of MSM had injected drugs within the previous 6 months, a figure that is considerably higher than among the general population 9…”